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Cycas circinalis L. is a multiuse cycad endemic to the Western Ghats, India. Cycas circinalis seeds and young leaves are harvested for food and medicine. The mature leaves are harvested for local rituals and for the floriculture industry, and the stems (piths) and male cones are extracted for medicine. The aim of this study was to identify patterns of use, harvest, and ecology of C. circinalis in the Nilgiri Biosphere Reserve (NBR), and to assess impacts on wild populations. Population structure analyses suggest that seed harvest does not negatively affect recruitment. However, populations subject to heavy leaf and/or pith harvest showed a lack of adult individuals. The high demand for C. circinalis, combined with the slow-growing nature of this species, suggests that conservation will require cultivation, use of substitutes, and better protection of the remaining wild populations.