Background The use of herbal medicine remains widespread among nursing mothers, particularly in rural communities. This is usually due to deep-rooted cultural beliefs, accessibility, and economic constraints. This study explored the factors influencing the rise of herbal medicine use and assessed knowledge on its effects on maternal and neonatal health among nursing mothers in the Likomba community, Tiko Subdivision, South West Region of Cameroon. Methods This community based cross-sectional descriptive study was conducted over an eight-month period from December 2024 through June 2025. The study population comprised the convenient selection of 186 nursing mothers residing in Likomba. Data were collected using pretested structured questionnaire. Data analysis was performed using the Statistical Package for Social Sciences version 20.0. The Chi square statistical test was used to assess association between variables and a P value <0.05 was considered statistically significant. Results This study revealed that 72% of the nursing mothers had adequate knowledge on the effects of herbal medicine use on maternal health. Also 68.8% had adequate knowledge on the effects of herbal medicine on neonatal health and 74.2% of the participants preferred herbal medicine because they have little/no documented adverse side effects. Conclusion The current study highlights that herbal medicine usage among nursing mothers is strongly influenced by cultural and socioeconomic factors, and that knowledge on its potential risks and benefits varies significantly with educational level.