This chapter examines the safeguarding of Indigenous Medical Knowledge (IMK) in Zimbabwe amid growing threats from biopiracy, commercialization, and socio-cultural modernization. The study employed a qualitative interpretive approach, using semi-structured interviews with twenty traditional medical practitioners in Masvingo, Mashonaland East, and Matabeleland South provinces, supported by documentary analysis of policy frameworks and literature. Thematic analysis revealed that practitioners experience limited legal awareness, fragmented policy frameworks, and inadequate benefit-sharing when their knowledge informs research or commercial products. Modernization processes such as urbanization and formal education further weaken traditional knowledge governance. Despite these challenges, practitioners employ safeguarding strategies including apprenticeship systems, community governance structures, selective knowledge sharing, and documentation initiatives to preserve and protect Indigenous Medical Knowledge.