Medicinal plants are a valuable resource for regional economic development in the tropics, and the Eastern Himalaya in particular harbours many such species. Extensive deforestation and over-exploitation in this region have brought several species to the brink of extinction, and Coptis teeta is such an endangered species; yet scientific information for its conservation is lacking. Investigations on the distribution range, demography, ecology, cytology, reproductive biology and population genetic structure of C. teeta were carried out; it was found to be endemic to a small area, to occupy a very narrow habitat and to be highly dispersed with very small population sizes. Edaphic factors were found to have played a vital role in ecological preference, natural distribution and evolutionary divergence of the species. The species exhibits a ‘K’ strategy, high male sterility, low reproductive success and efficiency, inadequate seed dispersal, and little genetic variability. A combination of these genetic hurdles and external threats in the form of habitat disturbance and over-exploitation for commercial purposes could result in its extinction. The species was found to have highly specific microsite requirements that cannot be met in other habitats. It is argued that in situ conservation measures would be the best strategy for the continued survival of this species. For effective management of the species it is recommended that its habitat be declared a protected area with the active cooperation of local inhabitants including the sharing of benefits of conservation.