The Garo tribe, one of a major indigenous communities of Meghalaya, India, relies heavily on their traditional health practices. This research investigates the healthcare-seeking behaviour of Garo women, their health concerns, their indigenous medical knowledge, and their reasons for preferring traditional over modern medicines. Conducted in East Garo Hills, Meghalaya, quantitative data (N = 96) were randomly collected from Garo women aged 15–49 through interviews to understand their health-seeking behaviour. Following a preliminary analysis, qualitative data (N = 12) were gathered through in-depth interviews to identify common illnesses, dimensions of traditional medicines, and reasons for dependency on them. Thematic analysis was performed using Atlas Ti. The result shows that almost 84% of Garo women (N = 86) seek treatment from Ojha (traditional healer) for achik (traditional) medicine, with only 6% using modern health facilities and 10% relying on herbal home remedies. Garo women rely on their age-old traditional remedies for health issues, irrespective of their educational or economic status. From the qualitative findings, this study explores the Garo tribe’s unique traditional medicine, known as ‘achik medicine’, prepared through local herbs and plants, and is disseminated by traditional healers, or ‘ojhas’, whose knowledge is generational. Moreover, every Garo household possesses medicinal plants, and all are knowledgeable about their use. Major health issues faced by Garo women are menstrual disorders, post-delivery weakness, fever with severe headache and jaundice. Reasons for using achik medicines are more effectiveness than modern medicines, cultural identity, preference for natural remedies, efficiency of Ojhas, availability, accessibility, and affordability of Ojhas. Meanwhile, the reasons for using limited use of modern healthcare facilities are poor quality of service and remote location. This study underscores the importance of preserving indigenous knowledge systems and respecting cultural heritage while ensuring the well-being of marginalised communities. Additionally, it highlights the need to improve modern healthcare quality and public transportation in the region.