Alpine plants are constantly subjected to extreme conditions like intense ultraviolet radiation, low temperature, and violent wind that contribute to the excessive production of reactive oxygen species (ROS) and resulting oxidative stress. To combat this stress, they have therefore evolved a robust antioxidant defense system with enzymatic and non-enzymatic components. Among enzymatic antioxidants, superoxide dismutase (SOD) reduces superoxide radicals to hydrogen peroxide, which is then detoxified by catalase (CAT) and ascorbate peroxidase (APX). APX, operating in the ascorbate–glutathione cycle, uses ascorbic acid as a substrate, whereas glutathione reductase (GR) sustains redox homeostasis through the regeneration of reduced glutathione (GSH). Guaiacol peroxidase (GPX) and various other peroxidases help in the elimination of peroxides during stress by catalysing the ROS. Non-enzymatic antioxidants such as ascorbic acid, glutathione, carotenoids, flavonoids, and osmolytes are also responsible for ROS scavenging and membrane stabilization. Furthermore, modulation in expression of transcription factors like DREB, MYB, NAC, and WRKY suggesting dynamic genetic regulation under stress conditions. These responses not only provide survival under oxidative stress but also ensure maintenance of medicinal property in alpine plants. Comprehension of these processes provides promising lines of approach for improving abiotic stress tolerance in plants via conservation practices and biotechnological strategies.