Threats include:

1) Intensive and species-specific removal for the live reef food fish export trade of a naturally uncommon and vulnerable species;
2) Readily accessible to spearfishing at night with SCUBA or hookah (i.e., compressed air) gear, and easy to catch with cyanide, or other poisons such as Derris trifoliata, due to predictable adult habitat and shallow depth range;
3) Lack of coordinated, consistent national and regional management largely due to limited management capacity and the sometime secretive nature of traders – in particular there is no relevant regional fishery management authority to address problems with this species;
4) Selective fishing, in particular the intensive take of juveniles for direct export sale and for grow-out (also referred to as ‘culture’ – the species cannot be hatchery reared; and
5) Illegal, unregulated, or unreported (IUU) fisheries (Donaldson and Sadovy 2001).

In addition, the species’ essential coral reef habitat is seriously threatened by human activity throughout the Indo-Pacific region. Destructive fishing practices, such as sodium cyanide use which stuns animals for capture and incidentally kills living coral, have been well documented and are spreading in the Indo-Pacific region (Barber and Pratt 1998, Burke et al. 2002, Bryant et al. 1998, Johannes and Riepen 1995). Despite its prohibition in many countries (including major exporters such as the Philippines and Indonesia), cyanide is still the preferred method for capturing certain live reef fish for international trade in some areas (Burke et al. 2002, Bryant et al. 1998, Johannes and Riepen 1995, Barber and Pratt 1998). Indeed, larger Humphead Wrasse are difficult to catch any other way, other than by night-time capture. When cyanide is applied, the fish often retreats into a crevice and becomes increasingly lethargic as the toxin reduces its ability to take up oxygen. Divers may break away the living coral to get access to the hiding area, and remove the fish to clean water where it will often recover for shipment or holding in net pens.

The most serious threat to this species is overfishing for the live fish export trade. They are mainly taken live for food – only rarely for the aquarium trade as far as can be determined. This species is long-lived and naturally uncommon, and if it is similar to other reef fishes of similar size and biology (e.g., sequential hermaphroditism; aggregation-spawner) it is expected to have low rates of replacement and therefore be particularly vulnerable to fishing pressure (Donaldson and Sadovy 2001). Moreover, being one of the largest of all reef fishes, they have few natural predators which means that fishing mortality may rapidly exceed natural mortality, possibly accounting for the rapid declines noted once fishing intensifies.

Although data are not available from throughout its range, wherever there are significant exports and no effective controls, fish numbers have declined substantially within a decade or less and exploitation rates are expected to continue, or more likely, intensify. There are few refuges for this species since live reef fish carriers have access to all reefs where it occurs and it does not extend into very deep water, probably little more than 60 m. Adults only occur in reasonable numbers where the fishery is effectively managed or where they occur in marine protected areas.

There has been speculation that Humphead Wrasse, and other reef fishes, can be cultured or "farmed" to meet international demand. However, it appears that the use of cultured fish may actually pose a threat to wild populations in certain circumstances since it does not involve hatchery production (not yet possible for this species and unlikely to be possible at commercial levels for many years according to experienced aquarist M.A. Rimmer, pers. comm.) but the grow-out of wild sourced juveniles.