Orchids are plant species with beauty and medicinal purposes, but, limited exploration has been conducted on potential utilization of Orchidaceae for medicinal purposes. This study aims to describe the local wisdom in utilization of Orchidaceae in traditional medicine and to identify the phyto-chemical content in particular orchid species which utilized for herbal medicine by local communities in the Lake Toba region. The study was conducted through exploration and in-depth interviews with 24 local communities that applied orchids in their traditional medicine in Karo, Simalungun and Toba of North Sumatra during 2020 to 2021. This study also reviewed various phyto-chemical content and safety issues of orchids utilization. The study identified about 23 orchid species from 15 genera as a main therapeutic agent. Various parts or entire plant are various parts of plant including roots, leaves, stems, flowers or entire plant contain phytochemical compounds with anti-inflammatory, anti-oxidant, antimicrobial, antipyretic properties, and applied for various medicinal. Some of well-known orchids are Anoectochilus formosanus and Calanthe triplicata. The entire plants are applied in traditional medicine to smooth the liver, to treat rheumatism, diabetes, bronchitis, wound infection, tonic or detoxification. These activities are due to various bio-Active compounds, mainly alkaloids, stilbenoids, dimeric phenanthrenes, flavonoids, triterpenoids, etc. These information have been illustrated the excellent potential of Orchidaceae for novel constituents of therapeutic and herbal medicine. © Published under licence by IOP Publishing Ltd.