The Sami people of northern Scandinavia and many indigenous peoples of North America have used pine (Pinus spp.) inner bark for food, medicine and other purposes. This study compares bark-peeling and subsequent uses of pine inner bark in Scandinavia and western North America, focusing on traditional practices. Pine inner bark contains substances – mainly carbohydrates, dietary fiber, vitamin C, and minerals – that were important complements to the protein-rich food of the indigenous peoples living in northern regions of both continents. The climate in these regions was (and is) sharply seasonal, and the stored carbohydrates in pine inner bark were particularly important during late winter. On both continents, a strip of live cambium was commonly left to show respect to the tree and the tree spirits and to ensure the tree's survival. The uses of pine inner bark and associated traditions have long time depths, and trees with old, or even ancient, bark-peeling scars are still common in old-growth pine forests on both continents. We conclude that forests with such trees should be regarded as relicts of traditional landscapes and protected for their cultural historical value.