The dispersed wetlands in the Darbhanga District of northern Bihar, India, provide a diversity of niches supporting substantial floral and faunal richness. The aquatic macrophytes of a representative range of perennial water bodies were surveyed fortnightly from June to September 2019, supported by a market survey undertaken with local stakeholders. A total of 61 species of vascular macrophytes was recorded, the majority of them Angiosperms (33 species of Dicotyledons from 21 families, and 26 Monocotyledons from 13 families) and two were Pteridophytes. This paper highlights the distribution pattern and potential commercial and medicinal values of aquatic macrophytes found in different wetland systems in northern Bihar. It further stresses their importance for subsistence, medicinal and economic purposes supporting the livelihoods of local people. Current trends and risks contributing to the degradation and loss of this diverse flora and its supporting habitats are considered. We recommend further assessment of the occurrence and values of this botanical resource, and extension of valuation to encompass the diverse additional ecosystem service benefits provided by the region’s wetland systems, as a basis for wetland conservation strategies founded on sustainable management and wise use, with particular reference to the potential for enhancing livelihood security of indigenous communities.