Traditional foodways are critical not only to food sovereignty in emerging and developing countries, but also to food security, eco-touristic development, small-scale food specialty markets, and local health strategies. We explore traditional knowledge concerning the fermentation of local plants (ethnozymology) for the production of medicinal and folk-functional foods perceived to have general health benefits. Field research was conducted in two Gorani communities in the mountains of NE Albania, located near the Kosovar border. Interviews were conducted with 44 study participants, and the fermentation of 15 plants for health purposes concerning disease prevention and health promotion was recorded. We discuss the role of fermentation in the production of local foods for health and its connections to community vitality and food security generally.