Background A lot of emphasis is often placed on modern governance systems and little or no attention is given to traditional governance practices which remain largely undocumented. The study aimed at finding out important traditional and modern governance practices that regulate traditional medicine sector in the Western Kenya. Materials and Methods The study was carried out in selected market centres of Western Kenya where the identified Traditional Medicine Practitioners (TMPs) sell their traditional medicine. All consenting TMPs and Professional Experts were interviewed with the aid of a semi-structured questionnaire. Purposive sampling design with elements of snow ball techniques was employed in tracing competent traditional medicine (TM) experts and relevant professional experts. The data collected was processed in Microsoft Excel and descriptive statistics performed. The Pearson’s Chi square statistics was carried out to determine the significance of the traditional and modern governance data sets using the STATA software. Results Modern governance practices were not significantly different in all the market centres surveyed (p=0.080). Equally, the traditional governance practices were also not significantly different in all the selected market centres (p=1.000). Conclusions Traditional governance practices play an important role in the governance of traditional medicine, and are shaped by the socio-cultural beliefs of the local communities. Modern governance practices, on the other hand, are widely perceived as top down regulation of the traditional medicine growing industry.