The ongoing use and protection of traditional medicines presents unique challenges for authorities, practitioners and stakeholders. With changes in the international intellectual property environment and biodiversity regulation, the Thai government has responded to ensure that traditional medicines, texts, traditional medical formulas, medicinal plants and herbs are protected through the development of a sui generis law. Drafted in 1999, the Act on Protection and Promotion of Thai Traditional Medicinal Intelligence is now being implemented in stages. Recent incidents, including controversies surrounding local and foreign patents over a Thai medicinal herb named kwao krua (Pueraria mirifica), have given impetus to traditional medicines protection, but have also tested the utility and implementation of the act by the Thai Department of Public Health. This article discusses the issues and implications in Thailand, while also reflecting on the approaches for traditional medicines protection internationally and in other countries.