This study evaluated the medicinal value and traditional uses of tree species in Kebbi State, Nigeria. Data were gathered through structured questionnaires and direct field observations from 360 respondents across multiple villages. Forty-five medicinal tree species representing 21 families were documented, with the Anacardiaceae family being the most prevalent. Leaves and bark were the most commonly used plant parts, often combined with other ingredients to treat a variety of ailments. The majority of respondents were male, aged 41–50 years, married, predominantly farmers, and had limited formal education. Knowledge of medicinal tree cultivation was largely self-taught; only a small proportion of respondents reported planting trees specifically for medicinal purposes—20.83% in Kebbi South, 22.5% in Kebbi North, and 25% in Kebbi Central. Most trees were planted primarily for environmental protection rather than medicinal use. Preparation methods mainly involved decoctions administered one to three times daily, depending on the ailment. These findings reveal a rich diversity of medicinal trees and extensive traditional knowledge, emphasizing the urgent need for conservation strategies to sustainably manage and preserve this ethnobotanical heritage.