The commercial harvesting, or large-scale exploitation, of alpine medicinal plants can lead to a range of consequences. This includes a direct decrease in population size and even local extinction if the harvest rate surpasses an irreversible threshold. Indirect ecological impacts may involve alterations to habitats and changes in interspecific interactions, which can reduce the survival and reproductive success of other organisms within the same community. Furthermore, commercial harvesting may influence plant phenotypes and affect their evolution. We present a case study on Fritillaria delavayi (Liliaceae) to illustrate how human collection affects the color evolution of this alpine medicinal herb. Ultimately, we emphasize that sustainable utilization, informed by local knowledge, is essential for the conservation of alpine medicinal plants.