The use of traditional knowledge in indigenous healthcare systems is vital for the conservation of floral diversity. The study was conducted between 2021 and 2023 to document and investigate the traditional utilization of medicinal plants in the Upper District Dir. A total of 79 species belonging to 34 different families were used to treat various diseases. Our investigations emphasize the importance of domestic consumption of plant resources for treating various human ailments. The dominant families were Lamiaceae (7 species), Asteraceae, and Amaranthaceae (5 species each). Herbaceous plants constituted the majority (73.15%), followed by trees (17.72%) and shrubs (10.12%). The study used descriptive ethnobotanical indices to evaluate the importance and conservation status of the species. These indices included Relative Frequency of Citations (RFC), Use Values (UV), Use Reports (UR), Fidelity Levels (FL), Informant Consensus Factors (ICF), Cultural Importance Values (CIV), Family Importance Values (FIV), and Medical Importance (MI). The UV varied from 0.90 (Taraxacum officinale L.) to 0.16 (Plantago lanceolata L. and Platanus orientalis L.) while RFC ranged from 0.75 (Teucricum stocksianum Boiss.) to 0.19 (Conyza canadensis L.). The species with the highest FL (95.69%) was Isodon rugosus Wall. where the lowest FL (0.44%) was recorded for Ocimum basilicum L. Similarly, CIV ranged from 3.74 to 0.04 for Teucricum stocksianum Boiss. and Bunium persicum (Bioss). The Family importance value ranged from 92.30 to 17.69, while the highest ICF of 0.62 was recorded for gastrointestinal diseases and urogenital problems. According to the results of the study, 24 plant species were classified as vulnerable, followed by rare (20 species), infrequent (13 species), and dominant (12 species), while 10 species were endangered. Practical usage of plant resources necessitates the implementation of conservation policies and further comprehensive research to optimize their sustainable utilization.