Natural or plant-based medicine provides an important link to resilience in a changing world and climate. With an ever-increasing demand for natural medicine, our wild medicinal plants, both globally and locally, are at risk of extinction. Due to discoveries of wild plants for our commercial drug and supplement use, wild populations are under increasing stress. Without international and local harvest standards, both large pharmaceutical companies and individual collectors could wipe out remaining threatened species. This research aims to describe the scale of overharvesting, specific plants at risk, an evaluation of case studies for success of conservation implementation strategies, and possibilities of small to large-scale cultivation of some species. Domestic plants researched include Echinacea, American ginseng, and Goldenseal. International case studies include implementation efforts in the Himalayas, Argentina, and Czech Republic. Cultivation, however successful it may be, still does not necessarily protect the wild population stands from individual harvesting nor does it guarantee equal medicinal properties. Economic, cultural, and biological evaluations are needed for the effected species to determine cultivation success and possible substitutions for more abundant medicinal plants.