In spite of heavy harvesting pressure on some of the most popular medicinal plant species, there are very few published studies concerning their conservation the semi-arid region of northeastern Brazil. In light of this fact, the present work sought to evaluate the local conservation and the harvesting sustainability of medicinal plants in an region of caatinga vegetation employing a fusion of biological and cultural approaches. Ethnobotanical methodologies and techniques were employed in the community of "Riachão de "Malhada de Pedra"" (municipality of Caruaru, state of Pernambuco, Brazil) in order to document local knowledge concerning medicinal plants and to examine the availability of those plants in a caatinga vegetation fragment located near that community. A total of 21 medicinal plant species were identified in the area and classified according to ecological factors and local uses. Two plants (Ziziphus joazeiro and Myracrodruon urundeuva) stood out has having high priority for conservation efforts. Sixteen species were identified as having populations adequate for harvesting through a system of pre-determined quotas, while four species were deemed sufficiently abundant to be harvested without risk of causing significant impact on their sustainability.