Background: Herbal medications are used worldwide for a variety of diseases and conditions. Patients often elect not to disclose their herbal use history, or health care practitioners fail to enquire about specific alternative therapy. The aim of this study was to assess the conditions most frequently self-treated with herbal remedies by patients visiting a tertiary hospital in Garankuwa, South Africa. Methods: Patients attending an out-patient's clinic at the Dr George Mukhari Academic Hospital were given a questionnaire regarding their use of herbal remedies for various reasons. Assessment was done on past, current, and possible future use of herbal interventions. These interventions were categorised into acute medical conditions, chronic ailments, and cultural uses. Results: Respiratory tract infections were most frequently treated (34%). Other highly ranked uses included protection from evil spirits (32%) and for HIV/AIDS (29%). Digestive ailments (27%), hypertension (18%), and general malaise (17%) accounted for the remainder. Previous herbal use amounted to 74%, but only 30% indicated that they would use herbal medication in future. Conclusions: Traditional medication plays an important role in many communities in South Africa. For this reason health care workers need to be aware of the conditions most frequently self-treated with herbal remedies. Having knowledge about the incidence of herbal treatment for a specific condition could alert the health care practitioner to possible reasons for unidentifiable drug interactions, adverse events, treatment failure, or even death.Keywords: chronic conditions, herbal remedies, out-patients, South Africa, traditional medicine IntroductionSouth Africa has 20 456 indigenous plant species of which 2 062 (~10%) are used for ethnomedicinal purposes according to the latest International Union for the Conservation of Nature (IUCN) Red List index assessment of South African plants surveyed in 2009. 1 These plants have been used in the treatment of various diseases, either as a primary intervention or an add-on alternative therapy since the earliest days in our history. The Voortrekker Louis Treghardt's 1836 diary describes the use of natural remedies for a multitude of diseases. 2 Without exception, visits to traditional healers are a familiar activity for many people who rely on ancestral knowledge passed down from one generation to the next. 3 This practice accounts for innumerable hospitalisations resulting from adverse effects and drug interactions. Despite this fact very few studies have been conducted on assessing the safety of these traditional medicines, which continue to be marketed as harmless forms of treatment with unsubstantiated and exaggerated claims in treating every disease known to man. 4 Moreover, legislative loopholes exist whereby traditional and herbal preparations may be sold without the necessary documented safety, efficacy, or drug interaction profiles needed for doctors to be aware of their potential harmful effects. 5 It is currently estimated th...