The Greater Khingan Mountains (GKM), located in the eastern Mongolian Plateau, are a multi-ethnic region predominantly inhabited by Mongolians, with the Han ethnic group forming the majority. The GKM serve as a vital plant germplasm resource and natural medicinal herb base in northern China. Through interactions with nature, Mongolians have developed distinctive traditional medicine cultures by discovering and utilizing wild plants for their healthcare, supported by oral traditions and practical knowledge accumulated over generations. This study comprehensively investigated the wild plants used in Traditional Mongolian Medicine (TMM) of the GKM, aiming primarily to: (1) promote the sustainable development and utilization of these plant resources by conducting an integrated assessment, and propose specific conservation strategies; (2) evaluate the commonalities and differences between TMM and local Mongolian Folk Medicine (MFM) applications, advance the protection and inheritance of traditional medicinal knowledge. From 2021 to 2023, multiple field investigations were conducted in the GKM to collect voucher specimens, which were integrated with the collation of previously collected specimens, taxonomic identifications, and also records of relevant literature, and the wild vascular plant species in this region were determined. On this basis, the inventory of the wild plants used in TMM of the GKM was established according to records in the Chinese Materia Medica: Mongolian Medicine Volume. By collating survey data from ethnobotanical studies in this region, the species and their utilization knowledge used by local Mongolians were obtained. The relevant information of the medicinal herbs that are industrially utilized by Mongolian Medicine pharmaceutical enterprises was obtained from their official websites. An Analytic Hierarchy Process (AHP) model was applied to quantitatively assess the development and utilization value of these resources. A total of 163 wild plant species used in TMM belonging to 118 genera and 55 families, dominated by Asteraceae, were identified in the GKM. Among them, herbaceous plants (87.73%) are predominant based on life forms, and mesophytes (77.30%) constitute the majority based on water ecotypes. In terms of distribution area, the southern regions hosted the highest species diversity (161 species), while there are no significant differences between the northern (138), eastern (135), and western (131) regions. A total of 133 Mongolian Medicine names correspond to 163 scientific species names, with 27 borrowed names derived from Tibetan, Chinese, and Sanskrit. Whole plants (77 species) and roots and rhizomes (43) are the primary medicinal parts that are harvested mainly in autumn. Among the total wild plant species used in TMM, 92 (56.44%) are used by local Mongolian folk, 69 (42.33%) are used industrially, while 50 (30.67%) have been documented in the literature but lack practical application. Among the 92 species used by local Mongolian folk, the medicinal parts of 31 species are identical to those in TMM, and 36 species partially similar to those in TMM, and the 25 species are different from those in TMM. The medicinal parts and effects of 8 species are different from the records in TMM. This area has a clear focus on the cultivation of wild medicinal plants, concentrating on the ecological cultivation of geo-authentic herbs. Based on the integrated assessment values, the species were categorized into four grades: highest value (36 species), high value (28), general value (69), and low value (30). The wild plants used in TMM of the GKM stand out for their rich plant diversity, widespread distribution area, exceptional medicinal value, and unique geo-authenticity. Mongolian Medicine names reveal multicultural integrations of the TMM. The comparison between TMM and local MFM not only confirms that traditional knowledge of MFM and TMM belongs to the same medical system, but also reveals valuable indigenous knowledge that unrecorded in the TMM. Locally and industrially used wild plants used in TMM demonstrate high utilization rates, reflecting their high medicinal value. Special attention should be given to underutilized species, particularly those documented in the literature but lacking practical application, to advance their large-scale utilization while ensuring effective conservation. Conservation strategies require the integration of strengthened legal regulations, public education and science popularization, nature reserve management, species-specific conservation initiatives, large-scale cultivation, and rational harvesting practices to achieve effective conservation and sustainable utilization of these invaluable resources.