There is a huge annual trade in Himalayan medicinal plants but only limited information on their sustainable use and conservation. The aim of this paper is to investigate if sustainable commercial medicinal plant management is promoted by forest policy formation and implementation in Nepal. Data was obtained through 175 semi-structured interviews with persons from five stakeholder groups involved in commercial alpine medicinal plant exploitation and conservation in Nepal: harvesters, traders, District Forest Office staff, staff at departments and ministerial level of the Ministry of Forests and Soil Conservation, and international and local NGOs and donors. The emphasis was on recording respondents' views on the official mechanisms regulating harvest of alpine commercial medicinal plants. It was found that current approaches to non-timber forest policy formation and implementation need to be revised if objectives of conservation and sustainable management are to be achieved. Identified problems include exclusion of harvesters from the policy formation process and widespread agreement among respondents that current collection permits and bans do not strongly affect resource utilization.