The study was conducted in the Al-Qassim region, located in the central plateau of the Kingdom of Saudi Arabia (approximately 25˚N-27˚N, 42˚E-44˚E). The region is characterised by an arid desert climate, with distinctive wild vegetation and a documented tradition of herbal healing practice. The geographical location of the study area is illustrated in Figure 1.

Figure 1. Location of the study area. (A) Map of the Kingdom of Saudi Arabia showing the position of Al-Qassim Province (highlighted in green). (B) Administrative districts of Al-Qassim Province, central Saudi Arabia. Maps adapted from Wikimedia Commons (public domain).

More than 40 traditional healers and herbal practitioners in the Al-Qassim region were contacted and invited to participate using purposive recruitment based on active practice and experience in the use of medicinal plants within the study area. Twenty individuals (16 women and 4 men) agreed to participate and completed the questionnaire; the remaining individuals did not respond or declined participation. Participants from outside the region, those with limited experience, and those who returned incomplete questionnaires were excluded. Participation was voluntary and written informed consent was obtained from all participants before data collection. No personal identifiers, biological samples, clinical procedures, or sensitive personal information were collected, and all information was analysed anonymously. In accordance with applicable local regulations for this type of non-interventional interview-based research, National Committee of Bioethics (NCBE), Kingdom of Saudi Arabia, Version 3, 2025, formal ethical approval was not required.

The final sample comprised the 20 eligible healers who responded to the invitation, agreed to participate, and completed the questionnaire. Because more than 40 potential participants were approached, the final sample reflects the response and availability of eligible traditional healers during the study period rather than a predetermined target of 20 participants. The exact response rate was not calculated because the total number of individuals successfully reached and eligible among all initial contacts was not recorded separately.

A structured questionnaire was developed on Google Forms and administered via face-to-face interviews in the local Arabic dialect between 14 March and 25 April 2026. The questionnaire captured the local names of plants, their reported medicinal uses, and the methods of preparation administered to patients.

Two quantitative indices were calculated. The Frequency Index (FI) expresses the proportion of informants who cited each plant species [9]:

FI = FC/N × 100

where FC is the number of informants citing the species and N is the total number of informants (N = 20). For Use Value (UV), one use report was defined as one distinct therapeutic indication for a given plant species reported by one informant. Synonymous descriptions referring to the same indication were consolidated, and repeated mentions of the same indication by the same informant were counted once. UV was calculated as [9]:

UV = ΣU/N

where ΣU is the total number of coded use reports for that species across all informants and N is the total number of informants (N = 20).

Vernacular plant names reported by the healers were matched to scientific names by the research team and cross-checked using relevant botanical literature, Plants of the World Online (Kew Gardens, accessed 2026), and World Flora Online. No plant material was collected and no voucher specimens were deposited; therefore, species assignments based on vernacular names should be interpreted with this limitation in mind. Plant growth forms were classified as follows: trees (perennial woody plants ≥ 6 m at maturity) [10]; shrubs (woody perennials < 2 m with basal branching) [11]; herbs (non-woody plants whose aerial parts die at the end of the growing season) [11].

Table 1 summarises the demographic and practice characteristics of the 20 participating healers. The majority were women (80%) and aged over 50 years (55%). Nearly half (45%) reported more than 20 years of experience in herbal healing. Family tradition was the most commonly cited source of therapeutic knowledge (50%), followed by learning from other therapists (25%). The largest monthly-caseload category was more than 20 cases per month (35%).

A total of 33 medicinal plant species were documented, distributed across 17 families (Table 2). Asteraceae, Apiaceae, and Fabaceae were the most represented families (15.15% each, 5 species each), followed by Lamiaceae (12.12%, 4 species).

Table 1. Characteristics of traditional healers participating in the study (n = 20).

Table 2. Ethnobotanical information of medicinal plants used to treat various ailments in Al-Qassim region, Kingdom of Saudi Arabia.

FI = Frequency Index, the percentage of informants who cited each plant species (FI = FC/N × 100, where FC = number of informants citing the species, N = total informants = 20); UV = Use Value, the average number of coded use reports per species per informant (UV = ΣU/N, where ΣU = total coded use reports for that species).

All remaining families contributed fewer species.

The documented species were grouped into six major therapeutic categories based on reported traditional uses (Table 3). Gastrointestinal and digestive disorders represented the largest category (10 species), followed by women’s health and reproductive conditions (8 species), anti-inflammatory, analgesic, and immune-support applications (7 species), metabolic and endocrine conditions (6 species), and respiratory and neurological conditions and skin and wound-healing applications (5 species each). Several species appeared in more than one category, reflecting the breadth of their reported traditional uses; the total number of category assignments (41) therefore exceeds the number of documented species (33).

Cuminum cyminum (cumin) and Commiphora myrrha (myrrh) recorded the highest FI (75% each), followed by Trigonella foenum-graecum (fenugreek, 70%). The lowest FI was recorded for Coffea arabica husk (5%). Pimpinella anisum (anise) recorded the highest UV (1.55), indicating the greatest average number of coded use reports per informant among the documented species. Full FI and UV data are presented in Table 2.

Table 3.Medicinal plant species documented in the Al-Qassim region grouped by primary therapeutic category, with frequency index (FI) of the most cited species per category (n = 33 species, total = 41 category assignments).

Note: Species with multiple therapeutic applications appear in more than one category. FI = frequency index (percentage of informants who cited each species).

Herbs were the predominant growth form (57.6%), followed by shrubs (24.2%), trees (15.2%), and subshrubs (3.0%) (Figure 2). Seeds were the most frequently used plant part (30.3%), followed by aerial parts (21.2%) and leaves (18.2%).

Figure 2. Plant form representation of plants used in Ethnobotany in Al-Qassim region, Saudi Arabia.

Figure 3. Percentage use of plant parts used in Ethnobotany in Al-Qassim region, Saudi Arabia.

Resin, roots, gum, fruit husks, and fruits each accounted for 6.1%. Flowers, pods, rhizomes, and gel were the least cited parts (3.0% each) (Figure 3).

Gastrointestinal complaints were the most frequently treated condition. Several Apiaceae species—Cuminum cyminum, Foeniculum vulgare, Pimpinella anisum, and Trachyspermum ammi—were used for digestive disorders, gases, and nausea. These uses are well-supported: C. cyminum demonstrates antioxidant and digestive effects [12][13]; F. vulgare has antispasmodic and gastroprotective properties [14]; P. anisum exerts antispasmodic and sedative effects [15][16]; and T. ammi has established gastroprotective activity [17]. Use of T. ammi for headache, however, lacks direct evidence and represents a research gap.

Among Asteraceae, Achillea fragrantissima, Artemisia herba-alba, and Artemisia judaica were all used for gastrointestinal conditions. Their antispasmodic, anti-inflammatory, and antimicrobial properties are documented [18]-[20], and A. herba-alba additionally shows glucose metabolism-modulating effects [21]. The reported use of A. judaica for Helicobacter pylori infection and appetite stimulation has not been directly confirmed in the literature. Senna alexandrina was used exclusively as a laxative, consistent with its well-established pharmacological activity [22]. Aloe vera was used for constipation and gastrointestinal inflammation, in line with its documented laxative and antimicrobial effects [23][24].

Women’s health was a prominent theme, reflecting the predominantly female healer cohort. Multiple species were used for menstrual regulation, labour support, and postpartum recovery. Anastatica hierochuntica was used to facilitate childbirth and stimulate ovarian function. Experimental evidence has reported effects on myometrial histology and prostaglandin levels [25], whereas reference [26] is a prenatal-toxicity study and does not support a cervical-ripening claim. Vitex agnus-castus was used to regulate the menstrual cycle and support pregnancy, consistent with its documented effects on menstrual disorders and its anti-inflammatory properties [27]. Origanum majorana was cited for hormonal regulation and reduction of insulin resistance, and clinical evidence supports its efficacy in polycystic ovary syndrome (PCOS) [28].

Trigonella foenum-graecum was used for lactation support, hormonal balance, and postpartum recovery—all well-supported uses [29]. Prunus mahaleb was used for postpartum support and menstrual cleansing; while antimicrobial and anti-inflammatory properties have been described [30], direct evidence for these specific uses is limited. Commiphora myrrha was used for uterine inflammation and postpartum discomfort; its broad anti-inflammatory, antimicrobial, and analgesic properties support these applications [31].

Several plants were used to regulate blood glucose and lipid levels. Teucrium polium was cited for blood glucose control, consistent with published evidence [32]. Nigella sativa was used for immune support and blood glucose regulation; robust evidence exists for its anti-inflammatory and antimicrobial effects, though glucose-lowering evidence remains insufficient [33]. Urtica dioica was used for blood glucose regulation and urinary tract health, in good agreement with its documented antidiabetic and analgesic properties [34]. Saussurea costus was used for glucose and lipid regulation, but direct evidence for these specific effects is lacking and warrants further study [35].

Curcuma longa (turmeric) was used as an anti-inflammatory and immune support agent. Its primary active compound, curcumin, has extensively documented antioxidant, anti-inflammatory, and immunomodulatory properties [36], and the traditional uses reported here are well-supported. Astragalus sarcocolla was used for wound healing and immune support; anti-inflammatory, antioxidant, and wound-healing effects are described in the literature [37][38]. Alkanna tinctoria was used for wound healing and burn scar treatment, consistent with documented anti-inflammatory and antimicrobial properties [39][40]. Its reported use for menstrual pain and respiratory conditions requires further investigation.

Acacia senegal (gum arabic) was used for kidney, urinary tract, and immune support; anti-inflammatory and prebiotic effects are documented [41]. Haplophyllum tuberculatum was cited for pain relief and digestive support, and analgesic, anti-inflammatory, and antioxidant properties have been reported [42]. Its use for menstrual regulation requires further study. Tamarix aphylla was used for headache relief and wound healing; antibacterial, anti-inflammatory, and wound-healing properties have been demonstrated [43], but its reported use to stimulate labour is not documented and requires safety evaluation.

Pimpinella anisum was used for respiratory complaints and infantile colic; antispasmodic and respiratory-protective effects are well established [15], though evidence for its use in infantile colic is lacking. Cymbopogon schoenanthus was used for headache, sinus congestion, and kidney health; antioxidant, antimicrobial, and anti-inflammatory properties are documented [44], and its analgesic effects may account for reported headache relief. Lepidium sativum was used for asthma, anaemia, and bone health; bronchodilatory effects, high iron content, and anti-inflammatory properties are documented [45]. Carthamus tinctorius was cited for depression and cardiovascular support; neuroinflammatory inhibitory and cardioprotective effects have been reported [46][47], though direct evidence for these traditional uses remains limited.

Several healer-reported uses require explicit safety caution. Teucrium polium has been associated with clinically significant herb-induced hepatitis, including reports after sustained oral use [48]; therefore, its traditional use for metabolic or gastrointestinal purposes should not be interpreted as evidence of safety. For Aloe vera, the inner leaf gel should be distinguished from the latex-containing outer leaf material: laxative effects are primarily associated with anthraquinone-containing latex, whereas the gel has a different composition and safety profile [23]. Particular caution is also required for remedies used during pregnancy, labour, postpartum periods, breastfeeding, and infancy because evidence on maternal, fetal, and infant safety is limited for many medicinal plants, and some herbal products have demonstrated uterotonic, embryotoxic, or teratogenic potential [26][49]. Accordingly, the present study documents reported traditional practices and does not endorse clinical use, dosage, or safety in these vulnerable groups.

Several limitations should be noted. The reliance on self-reported information from traditional healers introduces the possibility of recall bias. Although more than 40 potential participants were contacted, only 20 eligible healers agreed to participate and completed the questionnaire; this non-response and the restricted study period limit generalisability to the broader Al-Qassim healer population. The predominantly female healer cohort may have introduced a reporting bias towards women’s health conditions. Botanical identification relied on vernacular names matched to scientific names without collection of voucher specimens, creating uncertainty in species identity for some reports. Some reported uses are supported only by in vitro or animal studies, and extrapolation to human populations should be made cautiously. Notably, four species—Astragalus sarcocolla, Prunus mahaleb, Haplophyllum tuberculatum, and Tamarix aphylla—are supported by particularly limited evidence and represent priority targets for future clinical research.