The former royal city of Surakarta, Indonesia, is renowned for a uniquely cosmopolitan culture, blending high Javanese traditions with various peranakan (mixed ethnicity). This unique cultural fusion has facilitated the exchange of knowledge, particularly in relation to usage of various plants as phytomedicine by the urban populace. Therefore, this study aimed to explore the variety, utility, and phytogeography of phytomedicine available at Gede Hardjonagoro Market (Pasar Gede), the main market of Surakarta and Greater Solo Area (GSA). An ethnobotanical approach was used combining semi-structured interviews, participative observation, and documentation. The utility of plants was assessed through a descriptive and quantitative approach, using Use Value (UV) and Fidelity Level (FL) metrics. The results showed that a total of 76 species were found from 39 families of medicinal plants currently on sale in Pasar Gede. Zingiber officinale Roscoe had the highest UV, while 7 species had the highest FL (100%) including Elephantopus scaber for hepatitis, Sonchus arvensis for urolithiasis, and Gynura pseudochina for mastitis. Furthermore, Caesalpinia sappan was for pruritis, Myristica fragrans and Piper cubeba for diarrhea, as well as Curcuma heynaena for helminthiasis. Most species were native to Indomalayan realm (50 species), divided into Indochinese (21 species), Indian (12 species), Sunda Shelf (9 species), and others (8 species), with only 8 species found on Java Island. The results implied that trade routes and cultural exchange among peranakan ethnic group had contributed to the diversity of medicinal plants in Surakarta.