The powdered bark is used to treat pregnant women to determine the gender of an unborn baby. If a pregnant woman wishes to have a girl, she will take a preparation from the female plant and for a boy she will use the male plant. Traditional healers use the hard nut in their divining dice.

A decoction of the bark treats dysentery, diarrhoea, rheumatism and has a prophylactic effect against malaria. The bark is an excellent remedy for haemorrhoids. Roots and bark are also used as laxatives. A drink made from marula leaves is used for the treatment of gonorrhoea. Sometimes one finds a tree with a wound, probably caused by a traditional healer or someone who collected material for medicinal use.

In the former homeland of Venda it was a criminal offence to cut down a living tree of this species. The wood is used for furniture, panelling, flooring, carvings and household utensils like spoons. The inner layer of bark makes a strong rope. Drums and yokes for certain animals are made from the wood of this tree. In Namibia some people use the wood for sledges. Boats are also made from the trunk. Red-brown dye can be produced from the fresh skin of the bark. The gum, which is rich in tannin, is mixed with soot and used as ink.

The fruit is edible, eaten either fresh or made into a delicious jelly. It also makes alcoholic beer known as Mukumbi by the Vhavenda people. A marula liqueur is available commercially. The white nut is highly nutritious and is eaten as it is or mixed with vegetables. Fruit-farming communities prefer planting a couple of these trees to attract pollinators to their farm in early spring.