Andean grains are key elements in the construction of family production systems. These seeds speak of the history of a people, their customs and ancestral knowledge. The general objective of the work was to evaluate the food use, crop management and traditional knowledge about the medicinal use of ancestral Andean grains among the inhabitants of the districts of Quinua and Acos Vinchos (Ayacucho-Peru). Basic descriptive research, carried out by means of convenience sampling, the sample size determined by the Law of Diminishing Returns, after signing an informed consent form. Semi-structured individual interviews were applied to 96 informants. A total of 96.9% of the informants reported that they obtained quinoa grain from their own crops, and 24.0% obtained achita grain that they sowed directly on their land; no cañihua was cultivated. A total of 58.3% use quinoa and achita in their diet. The variability of the food use of ancestral grains, specifically quinoa and achita, constitute a natural source of vegetable protein of high nutritional value, which represents one of the main foods of the inhabitants of Quinua and Acos Vinchos. Traditional medicine derived from the ancestral knowledge of Andean grains is barely preserved, but this is not the case for other medicinal plants in the area, as this knowledge is still preserved.