In Tanzania, the trade of medicinal plant products has developed into a complex rural-to-urban supply network over time, influenced by changes in business environments at both macro and micro levels. At the macro level, shifts in policy and regulatory frameworks have played a significant role, while at the micro level, traders’ adaptive responses to these changes and to pandemics have shaped trade practices. Despite this, there is limited documentation on how traders have reacted to these evolving business environments and how the trade has developed over time.This study aimed to align historical changes in the business environment with empirical evidence of how medicinal plant trade has evolved in response to traders’ actions in Tanzania. Employing economic evolution theory, the study analyzed the interactions between environmental changes and traders’ responses to identify distinct evolutionary stages. Primary data were collected through ten focus group discussions and sixteen in-depth interviews with traders, regulators, and researchers across five regions in Tanzania. Findings reveal that traders adapted by enhancing product presentation and modernizing both their practices and business premises. The study identified four main evolutionary stages of medicinal plant trade in Tanzania: the colonial era (1882–1961), the government supremacy era (1961–1984), the emergence of the private sector (1985–2004), and the market and regulation integration era (from 2005 onwards). Furthermore, a fifth stage is anticipated due to the partial implementation of regulatory frameworks, expected to emerge when regulatory measures and market forces operate in tandem. The study recommends the enforcement of robust regulatory measures to achieve desired outcomes during periods of business environment changes in the traditional medicine sector. This is particularly crucial in preparation for the anticipated fifth stage, which is expected to feature intense competition among traders, necessitating resilient and innovative business models.