Vicuñas (Vicugna vicugna) and guanacos (Lama guanicoe) are the two species of wild South American camelids whose distributions range from Peru to northern Argentina and southern Peru to southern Argentina, respectively. Listed as critically endangered in the 1960s due to poaching, vicuña numbers had been gradually recovering; however, new concerns about population stability have arisen with recent observations of sarcoptic mange outbreaks in this species. Sarcoptic mange is an infectious skin disease caused by the microscopic burrowing mite, Sarcoptes scabiei, which infects nearly 150 mammalian species globally, including guanaco and vicuña. Wild camelid populations across Argentina, Bolivia, Chile, and Peru have been affected by sarcoptic mange, with the most severe outbreaks resulting in localized extirpation. Population declines have conservation and economic implications, as many local communities harvest vicuña and guanaco fiber for profit. We review the current literature on sarcoptic mange in wild camelids from Argentina, Bolivia, Chile, and Peru to establish a current state of knowledge on spatial prevalence, management, and therapeutics, and identify existing knowledge gaps. Critical next steps include 1) implementation of effective management strategies that limit the transmission of sarcoptic mange, 2) standardization of data collected during community capture (i.e., chaccu) events, 3) assessing the potential role of community captures in mite transmission, and 4) evaluation of treatment options and best practices for implementation. Further, there is a need for capacity building to improve disease diagnostics and surveillance in wild camelids. A multisectoral collaboration between governmental authorities, communities, academic institutions, and national and international organizations focusing on wild South American camelid conservation could contribute to building actions aimed at preventing future outbreaks and mitigating the current burden of sarcoptic mange disease.