Leishmaniasis is a neglected vector-transmitted tropical disease that primarily touches the poor in rural areas. In the Ecuadorian Amazon, affected populations are mostly Indigenous and face barriers to health care access. While meglumine antimoniate is the standard biomedical remedy for (muco)cutaneous leishmaniasis in this area, the quest for leishmaniasis healing is characterised by combining therapies. Based on multisited short-term ethnography, this study aims to understand health-seeking behaviours by exploring leishmaniasis patients’ therapeutic perspectives and practices. Through semi-structured interviews and focus groups, 28 patients living more than one year with (muco)cutaneous leishmaniasis help understand the decisions taken in the progress of the disease. Results confirm that all health-seekers resort to medical pluralism by applying (non-)physical therapies from biomedicine and traditional medicine influenced by family and community members. Traditional healers are preferred in the hinterland and lead traditional medicine therapies that include (witchcraft) cleansing, diet and behavioural recommendations like sleeping or eating apart. Health-seekers manifest that all treatments play a role in a successful cure, implying that symptom alleviation does not equal full recovery. The analysis first approaches the importance of social tissue as a determinant for leishmaniasis therapy choices guided by successful healing experiences. The disease’s perceived origin and therapy success are socio-culturally constructed. This leads to the second point of discussion, which explains that the apparent fluid movement of patients between medical systems mirrors the bargaining and adaptation of Indigenous Peoples to not only different epistemologies but also ontologies as a survival strategy in their forest lives. In the Indigenous holistic cosmovision of wellbeing, remedies act as agents –not objects–challenging the anthropocentric ontology of biomedicine that uses remedies as objects and symptom alleviation as health.