This paper investigates the perception of river dwellers in the Brazilian Amazon region about factors that influence the transmission of Traditional Ecological Knowledge (TEK) regarding medicinal plants. Semi-structured interviews were conducted with 43 residents of Vila Franca community (Pará, Brazil). The data were analyzed using the methodological strategy of the Discourse of the Collective Subject. The determining factors in the transmission of TEK were found to be: illness, family coexistence, and necessity, which were represented in the discourses as the most important factors for the acquisition of TEK. In the community context, the locally developed Natural Remedies Project, the beneficial effects of natural remedies, and the lack of resources to purchase allopathic medicines were cited as collaborative factors in the maintenance of TEK. Finally, the most significant determining factors in the decrease or loss of transmission of TEK found in the interviews were: lack of commitment, disbelief, and the valorization of allopathic medicines. A complex network of interactions between the villagers and their natural environment affects the transmission of TEK about medicinal plants. However, we found that the perpetuation of TEK is being threatened by various socio-economic and cultural factors.