[citation needed] In addition to its value for its timber and its medicinal uses, Prunus africana is an important food source for frugivorous birds and mammals.

Dian Fossey reports of the mountain gorilla:[12] "The northwestern slopes of Visoke offered several ridges of Pygeum africanum ....

East African Mammals reports that stands of Pygeum are the habitat of the rare Carruther's mountain squirrel, and asserts, "This forest type tends to have a rather broken canopy with many trees smothered in climbers and dense tangles of undergrowth.

In these later studies, the combined factors of mortalities of a large percentage of reproductive trees (especially the largest ones), highly reduced fruit production, and poor seedling survival seem to suggest a bleak prognosis for future regeneration and long-term persistence of the species in harvested populations.

The bark is used in numerous ways - as a wound dressing, a purgative, or an appetite stimulant, and to treat fevers, malaria, arrow poisoning, stomach pain, kidney disease, gonorrhoea, and insanity.

[22][23][24] The extract Pygeum is an herbal remedy prepared from the bark of P. africana and is promoted as an alternative medicine for benign prostatic hyperplasia (BPH).

[27][need quotation to verify] The timber is a hardwood employed in the manufacture of axe and hoe handles, utensils, wagons, floors, chopping blocks, carving boards, bridge decks, and furniture.

The wood is tough, heavy, straight-grained, and pink, with a pungent bitter-almond smell when first cut, turning mahogany and odorless later.

[1][28] P. africana continues to be taken from the wild, but quotas have been awarded by the South African Forestry Department without adequate forest inventories due to some harvesters, spurred on by the high prices, removing too much of the bark in an unsustainable manner.

In other languages spoken where it grows, it is known as tikur inchet in Amharic, kotofihy in Malagasy, mkonde-konde in Chagga, muiri in Kikuyu, entasesa or ngwabuzito in Ganda, uMkakase in Xhosa, inyazangoma-elimnyama or umdumezulu in Zulu, tendwet in Nandi (Kalenjin) and rooi-stinkhout in Afrikaans.

[16] A 1994/1995 study published in 1997 by Marchant and Taylor did a pollen analysis on and radiocarbon-dated two core samples from montane Mubindi Swamp in Uganda.

The investigators found montane Prunus, represented by currently growing P. africana, has been in the catchment continuously since their Pollen Zone MB6.1, dated about 43,000–33,000 years ago.