Traditional medicine beliefs are culturally important in some West African communities, where there is a thriving domestic consumer demand for wild animal derivatives. Yet, such practices can threaten the conservation of wild populations and negatively impact animal welfare. To identify those species most likely to be affected, we investigated wildlife derivative trade at the largest fetish market of West Africa in Togo. Specifically, we asked what wild animals or animal products were most profitable, which wild animals were perceived by vendors to have increased most in rarity and what they were used for. A key question was whether vendors also sold plant-based alternatives. Vendors provided 36 local animal names, from which we inferred an estimated 281 species. Thirteen percent of these inferred species are categorised on the IUCN Red List as threatened (n = 35); 26% are declining (n = 72). The most commonly cited most profitable wildlife derivatives were “Pangolin” and “Python”; the most commonly cited most profitable live wild animal was “Chameleon”. Overall, wildlife use was predominantly spiritual rather than medicinal. Plant-based alternatives were available, but comprised < 40% of sales and appeared to be considered less important or less useful than wild animal products. The legal status of this domestic trade in Togo is unclear given the existence of potentially conflicting national legislation. In addition to further research focused on the actual impacts on populations and individuals of the species indicated, socio-economic importance of this trade, societal pressures driving consumer demand and an assessment of the feasibility of sustainable plant-based alternatives is warranted.