Abstract Background Garo Hills represents one of earliest human habitation in Bangladesh preserving its ancient cultures due to the geographic location. It is situated in the most northern part of Durgapur sub-district having border with Meghalaya of India. Durgapur is rich in ethnic diversity with Garo and Hajong as the major ethnic groups along with Bangalee settlers from the mainstream population. Thus the ethnomedicinal practice in Garo Hills is considered rich as it encompasses three different groups. Present survey was undertaken to compile the medicinal plant usage among the various communities of the Garo Hills. Methods The ethnomedicinal data was collected through open and focussed group discussions, and personal interviews using semi-structured questionnaire. A total of 185 people were interviewed, including the three community people and their traditional health practitioners (THPs). The usage of the plants were further analysed and are presented as use value ( UV ), informant consensus factor ( ICF ) and fidelity level ( FL ). Results A total of 71 plants from 46 families and 64 genera were documented during our survey. Gastrointestinal disorders represented the major ailment category with the use of 36 plant species followed by dermatological problems (25 species). The ICF ranged from 0.90 to 0.99, with an average value of 0.96. Leaves (41) were the principle source of medication followed by fruits (27). Trees (33) were the major plant type used in the ethnobotanical practice. A total of 25 plants showed high FL (70.91 to 100 %) with 12 plants showing maximum FL (100 %). A number of the plants appear to have unique ethnomedicinal uses. Conclusion Present investigation revealed a rich traditional practice in the studied region, which provides primary health care to the local community. This compilation of the ethnobotanical knowledge can help researchers to identify the uses of various medicinal plants that have a long history of use.