Mexican indigenous people, as the Mazahua culture, safeguard, transmit and express a legacy of traditional knowledge related to nature. Mazahua use various organisms, among them lichens, to embellish their colorful wool textiles and to treat different bodily diseases. Our objective is to document Mazahua culture knowledge about lichens with dyer and medicinal purposes. We use general biological and anthropological methods usually employed in ethnobiological studies. Fifty Mazahua communities were visited, 430 semi-structured interviews in Spanish and Mazahua were applied altogether with lichenological photographic and organic stimuli. Ethnolichenological field trips were done guided by the locals, special orders were requested when the material was not found in the field, and finally participant observation was performed with the craftsmen and traditional healers to observe dyeing and medicinal preparation of the lichens. Thirty seven lichen species were identified, 31 used for dyeing and 22 for medicine to treat skin, pulmonary diseases, fever and /or toothache. Among the species used for both purposes are: Flavoparmelia caperata, Flavopunctelia flaventior, F. praesignis, Hypotrachyna neocirrhata, Parmotrema arnoldii, P. crinitum, P. eurysacum, P. paramoreliense, P. stuppeum, Pseudevernia consocians, P. intensa, Punctelia caseana, P. hypoleucites, P. perreticulata, Ramalina asahinae, Usnea arbusculiformis, and Usnea ceratina. Local linguistic variants to name the lichens were registered: xünza’a (“its tree’s leaves”), jüxü kja za’a (“what the tree has”), and ts’indaxidyo (“its tree’s little blanquet”). For Mazahua, lichens represent not only an important constituent of the forests, but a substantial component with dye and medicinal qualities which form an important part of their culture.