Echinacea angustifolia DC. (Asteraceae) is a major North American medicinal plant that has been harvested commercially in north-central Kansas for 100 years, making it one of the longest documented histories of large-scale commercial use of a native North American medicinal herb. We have compiled historical market data and relate it to harvest pressure on wild Echinacea populations. Interviews with local harvesters describe harvesting methods and demonstrate the species' resilience. Conservation measures for E. angustifolia also should address the other threats faced by the species and may include restoration and management of its mixed-grass prairie habitat and protection by private landowners.