The growing interest in therapeutic plants has become an important ecological concern in many developing countries, including Maseru. In these areas, traditional or ethno-medical systems still play a key role in primary healthcare. For many communities, plant-based remedies are the most affordable and accessible option, especially where modern medical services are limited or costly. This study investigates botanical remedies used for social and therapeutic purposes and examines how their increasing demand contributes to biodiversity decline. The research defines the ecological baseline as the original state of plant diversity and abundance before heavy harvesting began. This baseline helps measure the extent of biodiversity loss over time. The main objective is to understand the link between medicinal plant use and environmental sustainability. A mixed-methods approach was used, combining field data, community interviews and existing literature. Findings show that many households depend on medicinal plants for both healthcare and income through trade. However, increased commercialization and uncontrolled harvesting have placed pressure on wild plant species. Key results indicate that unsustainable practices, high demand and weak policy enforcement are driving the depletion of important flora and the degradation of ecosystems. The main contribution of this study is that it clearly links human dependence on botanical remedies with biodiversity loss. It also highlights the gap between conservation policies and their implementation and recommends sustainable harvesting, cultivation programs and stronger community-based management to protect biodiversity.