The global increase in the use of herbal remedies raises important public health concerns. Most Western-trained physicians are ignorant of the risks and benefits of this healthcare modality, and assessment of acceptance and knowledge would identify appropriate intervention strategies to improve physician–patient communication in this area. A cross-sectional survey was done using an interviewer-administered pilot-tested de novo questionnaire at six public hospitals in Trinidad between May and July 2004. The questionnaire utilised weighed questions to quantify acceptance (maximum score = 14 points) and knowledge (maximum score = 52 points). Acceptance and knowledge scores were analysed using ANOVA and Tukey’s tests. Of 192 physicians interviewed, most (60.4%) believed that herbal remedies were beneficial to health. Respondents had relatively high acceptance levels (mean = 5.69 ± 0.29 points or 40% of total possible score) and poor knowledge (mean = 7.77 ± 0.56 points or 15% of total possible score). Seventy-eight physicians (40.6%) admitted having used herbs in the past, and 60 of these (76.9%) were satisfied with the outcome. Although 52 physicians (27.1%) recommended the use of herbs to their patients only 29 (15.1%) were able to identify at least one known herb–drug interaction.