Home gardens are a pervasive component of Andean agricultural systems, but have been ignored in anthropological and agronomic research. Recent research in the indigenous community of Saraguro, Ecuador, employed a combination of in-depth interviews, free-listing, videotaped walk-throughs, and mapping to explore the role of home gardens, which are established and controlled by women. Findings reveal that, although gardens offer multiple benefits, they are overwhelmingly devoted to the cultivation of medicinal plants, operating as de facto medicine cabinets that supply women with most of the resources they need to treat family illnesses. Results also suggest that the natural history of home gardens mirrors transformations within the family, and that Saraguro women study the contents of their neighbors’ gardens, using this knowledge as a foundation for deciphering the owners’ economic and health status. New threats to the sustainability of home gardens threaten the foundation of Saraguro’s ethnomedical system and women’s authority in the home and community.