Ecological and ethnomedicinal survey of plants was conducted in one hundred and twenty homesteads in Mbala, Amuda, Umuaku, and Nneato communities of Nneochi Local Governement Area, Abia State-Nigeria. A total of ninety-one medicinal plant species belonging to seventy-eight genera and forty-eight families, used in the treatment of malaria, yellow fever, fibroid, hepatitis, convulsion, hypertension, diabetes, insomnia, ulcer, rashes, low sperm count, snake bite, among others, were documented. Plant remedies were prepared mostly as infusions or decoctions from different plant parts with mainly water, and palm wine/gin sometimes. The highest number of medicinal plant species (73) was recorded in Mbala, followed by Amuda (71), Umuaku (68) and Nneato (61). Medicinal plant species diversity was highest in Amuda (Simpson 1-D=0.9621;H=3.663), followed by Umuaku (Simpson 1-D=0.9481; H=3.471), Mbala (Simpson 1-D=0.9345; H=3.341), and Nneato (Simpson 1-D=0.9307; H=3.277), respectively. Similarity in medicinal plant species was highest between Umuaku and Nneato (76.71%), followed by Amuda and Umuaku (75.95%), Mbala and Amuda (71.43%), while Mbala and Nneato had the lowest similarity (59.52%). The results of the study showed that traditional medicine is pivotal in the treatment of ailments in the study area, and that the indigenous people of Nneochi have recognized the need to conserve medicinal plants of importance ex situ within homesteads due to threats from unsustainable exploitation and deforestation.