jats:titleAbstract</jats:title>jats:pThe preservation of the culturally important traditional herbal medicine practice in Ghana is threatened by the growth of allopathic medicine. It is argued that two main factors comprise this threat: significant safety concerns over many traditional herbal preparations, and a conflict in therapeutic frameworks which provides a substrate for the production of misinformation regarding allopathic medicine. Poorly enforced regulation of the commercial herbal market and a total lack of regulation of the traditional herbal market have led to prevalent contamination of herbal preparations with pathogenic bacteria and an unacceptable risk of pharmacological toxicity due to inconsistent production methods and understanding of the active components in these preparations. Simultaneously, misinformation spread by traditional herbal practitioners about allopathic medicine has caused significant morbidity and mortality in Ghana. Evidence from the literature and experience from clinical practice in a hospital in the Eastern region of Ghana are used to explore these factors and provide recommendations. First, thorough regulation of the herbal practice is needed to allay safety concerns. Second, the overall healthcare landscape will have to change to resolve the current tensions between practices. One solution would be the formation of a cooperative healthcare system which incorporates both the allopathic and herbal practices with well‐defined, nonoverlapping scopes of practice. However, such a novel landscape may be unrealistic, with the potential for traditional herbal practices being relegated to secondary role, mainly providing pharmacologically inert preparations while continuing to benefit patients through spiritual, cultural and pastoral interventions.</jats:p>