Across its entire range in Australia's western and southern rangelands, Australian sandalwood (Santalum spicatum [R.Br.] A.DC.) is on a path towards 'extinction in the wild' - the International Union for the Conservation of Nature's penultimate category of conservation risk. Sandalwood populations have substantially diminished or become locally extinct, predominantly a consequence of land clearing for agriculture, introduced grazers, disruption of key ecological processes (e.g. seed dispersal, fire regimes) and 175 years of intensive commercial exploitation for its fragrant, high value timber. The status of the world's last wild-harvested species of sandalwood is significant to both conservation and rangeland management, and the implementation of a science-based sustainable yield approach to management of this species is vital. By highlighting the scale and precipitous rate of decline and identifying key drivers affecting mortality and recruitment, this review outlines the conservation and restoration needs of the species in situ to conserve remaining wild populations, and the need to transition to science-based resource management actions such as farm-based plantation production.