The World Health Organization recently raised concerns about antimicrobial resistance and lack of novel antibiotics in the health sector. The success rate of drug discovery is higher when chemical constituents are sourced from natural products and when drug candidates are based on the indigenous knowledge of local communities. Tropical rainforests are an important source of medicinal plants for traditional healthcare systems. The pharmaceutical industry also recognizes the potential of rainforests in novel drug development. However, habitat degradation and loss of traditional knowledge are endangering the healing powers of nature. The islands of Fiji have a rich cultural history of traditional medicine and a number of medicinal plants are sourced from the country's rainforest ecosystems. While deforestation and forest degradation are decimating unique rainforest biodiversity and reducing access to medicinal plants in the wild, inter-generational erosion of ethnobotanical knowledge is attributed to acculturation, rural-urban migration and their effects on the transmission of oral traditions from one generation to another. Under these conditions, plants may disappear before their therapeutic value is formally identified. This review summarizes the importance of traditional medicinal knowledge and the potential for drug discovery from the tropical rainforest ecosystems of Fiji. However, there are several challenges that need to be addressed to realize the true potential of ethnopharmacology in this country.