Basotho healers and non-healers in southern Africa reported using Psilocybe maluti, a psilocybin-producing mushroom found in Lesotho and South Africa, for initiation, healing, recreation, and protection. In interviews with 26 healers and 8 non-healers, 15 healers and 6 non-healers independently identified the mushroom, and 5 healers described adding it to a psychoactive initiation brew used to intensify dreams and visions. The findings expand documented traditional psilocybin use beyond the Americas and show a different pattern than Western clinical or Mesoamerican models: smaller doses, mixed preparations, and use as one tool within a broader healing system.