Background <p>Hemorrhoids are a common but often under-reported health problem in Ethiopia, particularly in rural areas where access to biomedical services is limited. In such contexts, traditional healers play an important role in providing care for sensitive conditions, including hemorrhoids. However, empirical evidence on their practices remains limited. This study aimed to explore the diagnostic methods, treatment approaches, perceived effectiveness, and sustainability challenges of traditional hemorrhoid healers in the North Gondar Zone.</p> Methods <p>A qualitative cross-sectional study design was employed. In-depth semi-structured interviews were conducted with 15 purposively selected traditional healers. Data were analyzed using thematic analysis to identify key themes related to diagnosis, treatment, and challenges.</p> Results <p>The findings showed that hemorrhoids were primarily diagnosed through direct physical examination and patient-reported symptoms, without the use of biomedical diagnostic tools. Treatments mainly involved locally sourced medicinal plants, often combined with substances such as butter or honey, and administered through topical applications, herbal fumigation, or sitz baths. Participants reported strong confidence in the effectiveness of these treatments for early-stage hemorrhoids, while acknowledging limited effectiveness in severe cases. Key challenges included lack of legal recognition, environmental degradation affecting medicinal plant availability, social stigma, and weak collaboration with the biomedical sector.</p> Conclusion <p>Traditional healers play a significant role as primary healthcare providers in underserved communities. Strengthening their role through formal recognition, promoting sustainable use of medicinal plants, and fostering collaboration with biomedical services may improve healthcare delivery.</p>