Spiti valley is situated in cold desert of Trans Himalayan region of India and inhabited by Bhot or Bhotia tribal community. The average elevation of Spiti valley is about 4000 m and climate of the area is rugged, desolate and inhospitable. Many respiratory disorders such as cough, cold, asthma, pneumonia, chest infection, chronic bronchitis etc. and musculo-skeletal disorders such as joint pain, body pain, headache, muscular pain, backache are common in the area. Local people have strong belief in traditional system of medicine and still prefer to the use of herbal medicines prescribed by local herbal healers (Amchi). In order to study the traditional medicinal plants used for respiratory and musculo-skeletal problems in Spiti valley, the area was surveyed from 2009 to 2014. First-hand information on ethnomedicinal plants were gathered by taking interviews of local knowledgeable residents, women, elderly people, village headmen and Amchi (traditional doctors). A total of 88 plant species belonging to 69 genera and 30 families are reported from the study area which are used to cure various respiratory and musculo-skeletal diseases and conditions as folk treatment.