Harvesting of medicinal plants in the wild has an impact on sustainability of medicinal plants, which leads to the need for intervention in terms of conservation strategies. Siphonochilus aethiopicus, commonly known as African ginger or wild ginger is used to cure a variety of health conditions/illnesses, such as coughs, colds, asthma, nausea, headaches and pains. This study explored the potential role of indigenous knowledge on the uses, sustainability, and conservation strategies for African ginger among two communities in Mpumalanga province. Qualitative method entailing in-depth interviews was used for this research. We used a non-probability sample (snow-balling) to recruit ten (10) participants that comprised of four traditional health practitioners, four knowledge holders and two herbalists, considered experts on African ginger in the study area. The data was analyzed using thematic analysis. The diverse indigenous knowledge of the uses of African ginger was divided into two categories (diseases and spiritual/cultural purposes) among the local communities. African ginger is indigenous to South Africa and the plant species in the wild is mainly lost to commercial trade. As revealed by the participants, the multiple uses of African ginger are major contributing factors exacerbating the demands for the plant. The uses of African ginger have resulted in the scarcity and possibly extinction of this plant species in the wild, which remain a major concern to several stakeholders, especially traditional health practitioners. Harvesting of the rhizomes of African ginger is recommended instead of the root given the relative ease and higher chances for survival and regeneration. To ensure the sustainable utilisation of African ginger, its cultivation was recommended by the participants. However, there is a need for further intervention to assess how the community members can be assisted with developing and adopting indigenous conservation protocols for the continuous sustainability of African ginger. In addition, it is pertinent to strongly discourage the indiscriminate destruction of natural habitats and create more awareness on the importance of designating protected areas among local communities.