Abstract Surging demand for medicinal plant products may lead to unsustainable harvesting practices, which could put pressure on wild populations. Yet little is known about indigenous harvesters' preferences on key traditional Chinese medicinal plant resources, and how these might affect sustainable use and management. We conducted a discrete choice experiment with over 900 native Tibetan harvesters in the eastern Qinghai–Tibetan plateau in China, under a range of complex alternative livelihood, climate and environmental change, and land tenure and customs scenarios. We used random parameter logit model with broad heterogeneity to estimate local Tibetan harvesters' preferences and their willingness to harvest, and latent class logit model to explore distinct within‐population groupings based on shared preferences, for designing possible interventions. We uncovered three key findings with important management implications for medicinal plants. When given a choice, the local harvesters preferred not to harvest any herbs. However, if they opted to harvest, they preferred to harvest flowers and seeds, as compared to roots, and tended to use wooden tool (over the use of bare hands and iron tool). Notably, the degree of compliance with village rules and customs, and ecological worldview interact with targeted plant parts and potential income from harvest to influence their harvesting preferences. Their choices were sensitive to scenario‐based changes to livelihood options. Finally, our study revealed three distinct harvester groups with substantial heterogeneity. Specifically, two groups consisted of over 60% of the interviewed harvesters who appeared to have a strong preference for sustainable practices, while the remaining group lacks this tendency. Overall, our results shed light on the importance of understanding the drivers of harvesting preferences and the heterogeneity of harvesting practices among indigenous people and their cultural and sustainability leanings, providing crucial insights for future sustainable use and management of wild and economically important medicinal plants in the grasslands of Qinghai–Tibetan Plateau and other regions. Read the free Plain Language Summary for this article on the Journal blog.
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