Traditional medicinal plants are highly decreasing due to different threatening factors in Ethiopia. The present study was conducted in Gechi and Chewaka, Southwest Ethiopia. The study was conducted with 120 informants randomly selected from 12 kebeles selected by random sampling techniques. Data were collected using structured questionnaire, interview and group discussion. Furthermore, field observation based on a checklist was used. A total of 61 species categorized under 34 families were recorded. Fabaceae family had the highest number of species (6) followed by Asteraceae with 5 species. Five medicinal plants were used selectively to treat headache and shown as Ocimum lamiifolium ranked first in both woredas. Majority of the respondents (57% in Gechi and 48% in Chewaka) revealed that traditional medicinal plants are highly decreasing by different threatening factors. Expansion of agricultural land was the first ranked threatening factors reported by 31.67 and 26.67% respondents followed by lack of awareness (each 23.33%) and drought (each 18.33%) in Gechi and Chewaka respectively. The habitat distribution of medicinal plant was ranked in order of home garden agro forestry (75.47 and 73.91%) followed by forest land (67.93 and 71.74%) in Gechi and Chewaka woreda respectively and varies among the study sites for the rest land uses. In the study areas, local communities are giving less attention to conserve medicinal plants. Therefore, conservation strategies are highly needed to conserve these plant species.