Growing demand for ejiao – gelatin produced from donkey skin and used in Traditional Chinese Medicine – is putting global donkey populations at risk and threatening the livelihoods of millions of people that depend on them in lower and middle-income countries. Hundreds of thousands of donkeys are slaughtered for their skins and exported annually, mostly from Africa to China. However, the trade is spreading across the globe, including Brazil. This article highlights the appalling welfare conditions for donkeys caught up in both the legal and illegal trade, as well as the effects on vulnerable people and the potential for disease spread and hazards to human health.