The contemporary phase of increasing biodiversity loss; land-use intensification led to civilizations at the cost of natural resources is intricately linked to modern crises. Traditional knowledge is becoming a promising instrument in the contemporary state of global crises—especially on biodiversity loss and reaching out to sustainable development goals. The Hindu Kush Himalaya—a rich repository of biodiversity and culture—is in transition for development leading to biodiversity loss and cultural degradation. However, there are many traditional knowledge and practices, which are still contributing to biodiversity conservation at ecosystem, species, and genetic levels. This chapter brings a narrative of practices on traditional knowledge found in the region highlighting the contribution toward biodiversity conservation at ecosystem, species, genes, and its interfaces. There is a need for appreciation, recognition, and mainstreaming of some of these good practices in policies to ensure sustaining biodiversity and ecosystem services from the fragile mountains of the HKH.