Background: Respiratory tract infections (RTIs) are among the most frequent reasons for primary care consultation globally and constitute a major driver of antibiotic prescribing, much of which is unnecessary given that most RTIs are viral and self-limiting. Herbal remedies are widely used both in traditional medicine and as licensed phytopharmaceuticals for symptomatic management of RTIs, and their more formal integration into primary care is increasingly discussed as a potential complement to antimicrobial stewardship initiatives. Content: This concise narrative review integrates evidence from Cochrane systematic reviews, other systematic reviews and meta-analyses, and regulatory and ethnobotanical literature concerning herbal remedies used for RTIs. It focuses on Pelargonium sidoides, Echinacea species, ivy leaf (Hedera helix), honey, and other plant-derived agents. The review evaluates the comparative robustness of trial evidence for individual remedies, examines safety issues including herb–drug interactions, outlines the regulatory frameworks governing herbal products internationally and in Nigeria, and considers the practical constraints and opportunities associated with incorporating evidence-supported remedies into routine primary care. Summary: The strength and consistency of the evidence base differ across remedies. Pelargonium sidoides, ivy leaf, and honey are supported by clinical trial data suggesting modest symptomatic benefit and generally favourable safety profiles. In contrast, evidence for Echinacea preparations remains heterogeneous and often inconclusive. Regulatory oversight of herbal products in Nigeria is expanding but continues to display substantial gaps in implementation and enforcement. Outlook: More systematic integration of herbal remedies into primary care management of RTIs will depend on improved product standardisation, structured clinician training in evidence-based phytotherapy, and additional context-specific clinical trials, particularly within African primary care settings.

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