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Camellia longzhouensis (Theaceae) is an endemic evergreen shrub or small tree with a distribution restricted to South China. It is listed as Grade-II in the National Key Protected Wild Plants List. In this study, we surveyed its distribution, examined its population structure, identified factors affecting its survival, and reassessed its extinction risk. We found that C. longzhouensis was only distributed in the Nonggang National Nature Reserve and the surrounding area. Its individuals only grew under the secondary forest canopy in the karst mountain. A total of 58 individuals of C. longzhouensis in three sub-populations were found. Soil fertility and understory light availability were the main habitat factors influencing the survival of C. longzhouensis. Anthropogenic disturbances and reproductive obstacles have caused a low seed-setting rate, poor seedling survival, and a lack of adult plants of C. longzhouensis in the natural habitat. The population structure of C. longzhouensis is spindle-shaped, indicating poor natural regeneration and inhibited seedling recruitment. Cleistanthus petelotii had a significant positive interspecific interaction with C. longzhouensis in the community. Based on the information obtained here and IUCN criterion C2ai, we recommend that C. longzhouensis be categorized in the International Union for Conservation of Nature (IUCN) Red List as Critically Endangered. We also developed a comprehensive protection strategy, consisting of in situ conservation, ex situ conservation, reintroduction, and commercial utilization. This strategy can be readily applied to protect other endangered plants with economic value in karst poor regions.