AbstractThe harvest of wild plants with medicinal uses is increasing globally, both for self‐treatment and as a source of income. The increasing demand for these remedies could lead to the over‐harvest of some species. Despite a recent surge in the number of studies analysing wild medicinal plants management, little is known about the effects of non‐commercial harvesting on the conservation status of medicinal plants.We explore the connection between the cultural importance (CI) of medicinal vascular plants traditionally used in Spain for self‐treatment and their availability, conservation and legal protection status, and discuss the implications of our results for sustainability. We focus on Spain, located in one of the world's 25 biodiversity hotspots and the most diverse country in Europe regarding vascular plants (7071 species, 1357 endemic), while also being culturally and linguistically diverse.Spain has a rich body of traditional knowledge referring to wild medicinal plants, with 1376 species with medicinal uses, which represents nearly a fourth (22%) of the total autochthonous vascular flora of the country (16% endemic). Species CI is positively correlated with abundance (ρ = 0.466) and occupancy area (ρ = 0.495). Only 8% of the wild medicinal plants traditionally used in Spain have an endangered conservation status and just 6% are fully or largely affected by protection measures. Most species used for self‐treatment in Spain are common, highly available and not threatened. This suggests that domestic use alone does not result in overexploitation and that traditional knowledge systems of plant management might ensure their sustainability.Read the freePlain Language Summaryfor this article on the Journal blog.