The present article provides a multifaceted critical research review on environmental issues intimately related with the socio-economy of North East India (NE), a part of Indo-Burma hotspot. Further, the article addresses the issue of sustainable development of NE India through diverse ecological practices inextricably linked with traditional ecological knowledge (TEK). The biodiversity of NE India comprises endemic floral diversity, particularly medicinal plants of importance to pharmaceutical industry, and unique faunal diversity. Nevertheless, it is very unfortunate that this great land of biodiversity is least explored taxonomically as well as biotechnologically, probably due to geographical and political constraints. Different anthropogenic and socio-economic factors have perturbed the pristine ecology of this region, leading to environmental degradation. Also, the practice of unregulated shifting cultivation (jhooming), bamboo flowering, biological invasions and anthropogenic perturbations to biodiversity exacerbate the gloomy situation. Instead of a plethora of policies, the TEK of NE people may be integrated with modern scientific knowledge in order to conserve the environment which is the strong pillar for socio-economic sector here. The aforesaid approach can be practiced in NE India through the broad implementation and extension of agroforestry practices. Further, case studies on Apatanis, ethnomedicinal plants use by indigenous tribal groups and sacred forests are particularly relevant in the context of conservation of environmental health in totality while addressing the socioeconomic impact as well. In context with the prevailing scenarios in this region, we developed an eco-sustainable model for natural resource management through agroforestry practices in order to uplift the social as well as environmental framework.