Notholithocarpus densiflorus (Hook. & Arn.) Manos, Cannon & S.H. Oh (Fagaceae) (tanoak) needs immediate conservation attention due to the threat posed by Phytophthora ramorum Werres, de Cock & Man in't Veld, the water mold responsible for sudden oak death. This article explains the significant cultural value of tanoak and the seriousness of the sudden oak death threat. Current efforts to limit the spread of P. ramorum are not working adequately to prevent pathogen spread and maintain healthy ecosystems. The heartland of tanoak's distribution in northern California is at risk. I advocate for a collaborative process with tribal leadership to identify areas with mature tanoaks where traditional indigenous burning practices can be tested in combination with best management practices informed by western science. New approaches are needed to tend to tanoaks despite the sudden oak death pathogen and other threats.