The use of medicinal plant species for different therapeutic effects is well recognized around the globe. Nardostachys jatamansi (D.Don) DC. (Family: Caprifoliaceae Juss.), commonly known as Indian spikenard is a critically endangered medicinal plant which grows at high altitudes in the alpine and sub-alpine regions of the Himalayas. Its medicinal use is well-recognized in the Bhutanese, Chinese, Indian, Japanese, Nepalese and Tibetan medicine. Moreover, its medicinal properties are well established in traditional medicines including Ayurveda, Ben-Cao- Shi-Yi, Homer's Iliad, the Old Testament, as in conventional systems. The increasing national and international demand of N. jatamansi, mostly for the rhizomes (underground tissue), as well as illegal/unsustainable harvesting has brought this valuable species to the edge of extinction. Therefore, more research input including in vitro biotechnological approaches is required to ensure its sustainable utilization and long-term conservation. Further research is also needed to improve our current knowledge about its conservation status, clinical relevance, and bioactive components. This review comprehensively summarizes the currently available information on the ethnomedicinal uses, pharmacology, phytochemistry, trade value and potential role of modern plant biotechnology tools for the conservation of this high value plant. (c) 2020 SAAB. Published by Elsevier B.V. All rights reserved.