An introduced pathogen, white pine blister rust (Cronartium ribicola), has caused declines in five-needled pines throughout North America. Simultaneously, fire exclusion has resulted in dense stands in many forest types, which may create additional stress for these generally shade-intolerant pines. Fire exclusion also allows fuels to accumulate, and it is unclear how affected populations will respond to the reintroduction of fire. Although white pine blister rust and fire exclusion are widely recognized threats, long-term demographic data that document the effects of these stressors are rare. We present population trends from 2168 individuals over 5–15 years for an affected species, sugar pine (Pinus lambertiana), at several burned and unburned sites in the Sierra Nevada of California. Size-based matrix models indicate that most unburned populations have negative growth rates (λ range: 0.82–1.04). The growth rate of most populations was, however, indistinguishable from replacement levels (λ = 1.0), implying that, if populations are indeed declining, the progression of any such decline is slow, and longer observations are needed to clearly determine population trends. We found significant differences among population growth rates, primarily due to variation in recruitment rates. Deaths associated with blister rust and stress (i.e., resource competition) were common, suggesting significant roles for both blister rust and fire exclusion in determining population trajectories. Data from 15 prescribed fires showed that the immediate effect of burning was the death of many small trees, with the frequency of mortality returning to pre-fire levels within five years. In spite of a poor prognosis for sugar pine, our results suggest that we have time to apply and refine management strategies to protect this species.