BackgroundHerbal medicine has been used for the treatment of human and livestock ailments since ancient times. Numerous rural and urban communities in Ethiopia practice traditional medicine and transfer the knowledge verbally from generation to generation. Thus, this study was conducted to document the traditional medicinal plants and associated indigenous knowledge in Dibatie district, Metekel zone, Benishangul Gumuz Regional State, western Ethiopia.MethodsThree hundred seventy-four (374) informants from 11 kebeles (the smallest administrative units) were selected and participated in the data delivery. The ethnobotanical data collection was carried out using semi-structured interviews, preference ranking, direct matrix ranking, field observation, market surveys, and focus group discussions, including voucher specimen collections. The ethnobotanical data were analyzed using descriptive statistics (frequency and percentage), ranking, comparison, and quantitative ethnobotanical techniques such as informant consensus factor, fidelity level index, Jaccard’s coefficient of similarity, and use value index.ResultsA total of 170 plant species were recorded to treat 79 human and 29 livestock ailments. Fabaceae (with 20 species) and Asteraceae (with 18 species) were the most dominant medicinal plant families in the area. Most remedial plants were herbs (61 species, 35.88%), followed by shrubs (39 species, 22.94%). The majority (135 species, 79.41%) of medicinal plants were harvested from wild sources and mainly possessed multiple remedy parts (41.17%) that are usually prescribed in fresh form (60.13%). The most commonly reported human ailment was snake venom, while blackleg was mostly reported among livestock diseases. The herbal medicines were mostly administered orally (52.20%), followed by dermal (17.62%) application. Embelia schimperi Vatke, Glinus lotoides L., Haplosciadium abyssinicum Hochst., Mucuna melanocarpa Hochst. ex A. Rich., and Phragmanthera macrosolen (Steud. ex A. Rich.) M.G.Gilbert had the highest fidelity level values (100%) against the corresponding ailments.ConclusionThe study area is rich in a diversity of potential medicinal plants and associated indigenous knowledge. Thus, appropriate conservation actions and careful utilization are essential to counteract the rise of anthropogenic threats and to ensure the continuity of plants with the related indigenous knowledge. Additionally, the medicinal plants should be validated through experimentation to integrate local knowledge with modern medications.