This study documents indigenous medicinal plant utilization, management and the threats affecting them. The study was carried out in Mana Angetu district between January 2003 and December 2004. Ethnobotanical data were collected using semi structured interviews, field observations, preference and direct matrix ranking with traditional medicine practitioners. The ethnomedicinal use of 230 plant species was documented in the study area. Most of the plants (78.7%) were reportedly used to treat human diseases. The most frequently used plant part were roots (33.9%), followed by leaves (25.6%). Most of the medicinal species (90.4%) were collected from the wild. Direct matrix analysis showed that Olea europaea L. Subsp. cuspidata (Wall. ex G. Don) was the most important species followed by Acacia tortilis (Forssk.) Hayne (120) indicating high utility value of these species for the local community. The principal threatening factors reported were deforestation (90%), agricultural expansion (85%) and fire (53%). Documenting the eroding plants and associated indigenous knowledge can be used as a basis for developing management plans for conservation and sustainable use of medicinal plants in the area.