Outside the established legal framework of intellectual property rights, countries have pursued multiple pathways to protect and promote traditional medicine. As Tibetan medicine is a late entrant into commercialization, the proposals to propertize generally fall within the rationale of existing sui‐generis paradigms of Intellectual property. In this context, the article enquires the state of innovations in this sector viz‐a‐viz the property right approaches in place especially in India and China. It argues that beyond the usual complex medical science and technology led—innovations, the pathways of cumulative processes and creative additions through informal experiential learning platforms, where the transfers of knowledge become part of livelihood and social benefits (we call them “below the radar innovations”) is ubiquitous in Tibetan medicine. The trends and politics in two recent strategies of protection, that is, Tibetan medicine as economic property (emphasizing patents here among many others) and as a cultural property (intangible cultural heritage) are juxtaposed with these informal innovative attempts. The paper underlines that the productivity‐based economic rationale of these protection mechanisms should not obscure sustainability alternatives of “below the radar” (BtR) innovations in Tibetan medicine.