Trillium govanianum, a perennial and endangered high-altitude herb, is valued for its high content of steroidal saponins. Traditionally, the species has been part of many ethnobotanical applications with the local communities for various health and spiritual benefits. As the species has found its use in modern medicine owing to its anti-inflammatory, antioxidant and anticancer activity, it has been harvested/extracted illegally and unsustainably from its natural habitat. This harvesting and subsequent trade have left the species in a dwindling state, with habitat fragmentation, degradation and a loss of genetic diversity. To highlight the urgent need for the ecological preservation of Trillium govanianum, this chapter highlights the species’ different characteristics, such as habitat and distribution, biological attributes, and traditional and modern medicinal uses. The chapter then examines the conservation challenges and subsequently discusses the multidimensional conservation strategy, which is to balance the economic needs of local communities with ecological preservation, thereby affecting the genetic resilience of T. govanianum in its natural habitat.