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Profound socioeconomic changes affected mountains of Central Italy during the last century and many traditional agro-pastoral activities were abandoned. A few ethnobotanical studies in this area have specifically documented local wild plants used decades ago, but without analyzing in-depth how and why Traditional Ecological Knowledge (TEK) has eroded or changed over time. In this study, we 1) document ethnobotanical uses of four high-altitude remote villages of Central Italy, 2) discuss how these uses have changed over time, comparing them with fieldwork that was conducted 40 years earlier; and 3) assess how plant uses have changed across space, particularly whether the remoteness of villages or the occurrence of Sacred Natural Sites (SNS) have affected TEK linked to wild plants. Sixty semi-structured interviews revealed the use of 83 taxa belonging to 35 families. We did not find any relationship between SNS and the richness of TEK, as these SNS were not inhabited by monastic communities that could have shared their scholarly knowledge. There was not a relationship between remoteness and richness of TEK. The common statement emerging from the field, "We became rich and lost everything", revealed how socio-economic changes resulted in the rapid abandonment of traditional practices, while the ubiquity of pharmacies may have contributed to the erosion of ethnomedicinal knowledge. [ABSTRACT FROM AUTHOR]