The primary threat to Alepidea amatymbica is over-exploitation for the traditional medicine trade. The species, which is known by the Xhosa as Iqwili, and Ikhathazo by the Zulu, is extremely popular and in high demand. Dold and Cocks (2002) found Alepidea amatymbica to be one of the 20 most prevalent species in Eastern Cape ‘muthi’ markets, and estimated that more than 1 200 kg were sold annually in the region. This species is always present at the King William’s Town market with material sourced from Pirie, Gwiligwili, Cata, Katberg and other parts of the former Ciskei escarpment, where there is no regulation of natural resource exploitation (A.P. Dold pers. comm. 2016). The high demand for this species has led to over-exploitation in some areas. Traders and harvesters report that it is no longer present in the source areas for the Mthatha market, indicating that it has now very scarce in Transkei area of the Eastern Cape (S. Cawe, Xhosa ethnobotanist, pers. comm. 2016). Field surveys for a taxonomic revision of Alepidea sections Setiferae and Leiocarpae (Hutchinson 2016) found this species difficult to locate in the wild in all but the most inaccessible areas of the Eastern Cape. At Mount Insizwa in the Mount Ayliff district, local herdsmen informed researchers that harvesters had eradicated all A. amatymbica plants on the lower slopes. Remaining subpopulations could only be reached after more than an hour’s walk to more inaccessible areas near the mountain summit. Increasing scarcity of plants in the Eastern Cape have led to harvesters starting to target subpopulations on privately owned farms. Landowners in the Hogsback area are reporting large loads removed by vehicle from their farms (A.P. Dold pers. comm. 2016). A. amatymbica is not just heavily exploited for Eastern Cape traditional medicine – it has also been recorded in trade as far as the Faraday Market in Johannesburg (Hutchinson 2016) and used by Rastafarian herbal healers in Cape Town (Nzue 2009). Over-exploitation of wild populations is also occurring in KwaZulu-Natal. A small study conducted in the Coleford area, southern Drakensberg, found that the species had virtually disappeared from communally owned areas, but could still be found in relative abundance on access-controlled privately owned land (O’Connor 2004). The maximum recorded density in privately owned areas was 5.7 plants/sq. m (mean = 1 plant/sq. m), but no plants were seen after nine hours of searching in adjacent communal areas, suggesting it had been eradicted from communal areas. It is important to note that were suitable habitat exists, A. amatymbica can be very common, even locally dominant. However, at a landscape level, it is relatively scarce because the areas of suitable wetland habitat are usually small (O’Connor 2004). O’Connor (2004) further estimated that the Coleford subpopulation had less than 180 000 individual plants, and that if 1.82 million plants were harvested annually for the Durban market (as cited by Mander 1998), then 10 areas equivalent to Coleford were being cleared annually for one market.