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Semi-arid to sub-humid subtropical regions harbor a wealth of biodiversity, including numerous medicinal plant species that have been utilized for centuries by indigenous communities for various health purposes. This comprehensive review article delves into the intricacies of flora diversity and the conservation status of medicinal plants within these ecologically significant regions. Drawing upon a vast array of research studies, ethnobotanical surveys, conservation reports, and traditional knowledge systems, we provide a detailed examination of the richness of plant species, their medicinal properties, conservation challenges, and strategies for sustainable management. By synthesizing multidisciplinary insights, this review aims to inform conservation efforts, promote sustainable use practices, and enhance our understanding of the cultural and ecological importance of medicinal plants in semi-arid to sub-humid subtropical environments.