While the demand for many products from wild-harvested plants is growing rapidly, the sustainability of the associated plant trade remains poorly understood and understudied. We integrate ecological and trade data to advance sustainability assessments, using the critically endangered Nardostachys jatamansi in Nepal to exemplify the approach and illustrate the conservation policy gains. Through spatial distribution modeling and structured interviews with traders, wholesalers, and processors, we upscale district-level trade data to provincial and national levels and compare traded amounts to three sustainable harvest scenarios derived from stock and yield data in published inventories and population ecology studies. We find increased trade levels and unsustainable harvesting focused in specific subnational geographical locations. Data reported in government records and to CITES did not reflect estimated trade levels and could not be used to assess sustainability. Our results suggest that changing harvesting practices to promote regeneration would allow country-wide higher levels of sustainable harvests, simultaneously promoting species conservation and continued trade of substantial economic importance to harvesters and downstream actors in the production network. The approach can be applied to other plant species, with indication that quick and low-cost proxies to species distribution modeling may provide acceptable sustainability estimates at aggregated spatial levels.