The combined effects of changes in climate and land use on tree mortality and growth patterns have rarely been addressed. Relict tree species from the Mediterranean Basin serve as appropriate models to investigate these effects, since they grow in climatically stressed areas which have undergone intense cover changes. The aim is to use climate, aerial photographs, stand structure and radial-growth data to explain the mortality and historical patterns of growth of Abies pinsapo in the area where this relict species was first protected. Sierra de las Nieves, West Baetic Range, southern Spain. We assessed variations of tree cover in A. pinsapo forests through image analyses of aerial photographs spanning the last 50 years. We sampled 31 stands to assess current altitudinal patterns of forest structure and mortality. We evaluated the relationships between radial growth and regional climate using linear models in three sites at different elevations. Regional warming and a decrease in precipitation were detected. Forest tree cover increased at all elevations from 1957 until 1991, but it afterwards decreased below 1100 m. Currently, the likelihood of tree mortality increases downwards and is associated with dense, closed stands with a low living basal area. In contrast to previous droughts, a sharp synchronized reduction in tree growth, not fully accounted for in linear climate-growth models, occurred at low elevations in 1994-95, but not upwards. It was preceded by a weakening of the negative association between low-elevation growth and water deficit since the late 1970s. The intense densification of A. pinsapo forests following strict protection measures in the late 1950s enhanced the vulnerability of climate-sensitive A. pinsapo forests to recent drier conditions. Such abrupt land-use changes help to explain recent patterns of mortality and growth decline in low-elevation A. pinsapo forests.