This study estimates the national-level annual volume and value of commercial medicinal plant harvest in Nepal. Data were collected using open-ended questionnaires administered to local medicinal plant traders (n = 149) in 15 districts in Nepal and regional wholesalers (n = 53) in India. The annual trade volume is estimated to range from 7000 to 27 000 tons, with 14 500 tons harvested in the case year 1997–1998. The corresponding annual export value, calculated using regional wholesaler purchasing prices in the main markets in India, is estimated at US$7–30 million, with a value of US$16 million in 1997–1998. Around 10% of rural households are involved in commercial harvesting. Lower ecological zones dominate supplies in both volume and value terms; herbs constitute the most important life form in value terms. Around 36% of volume and 51% of value derive from destructive harvesting. It is argued that annual volume and value figures are likely to be conservative estimates. The implications of findings for Himalayan medicinal plant conservation and trade are briefly discussed.