The Tibetan gazelle Procapra picticaudata is endemic to the Tibetan plateau. In the Ladakh region of northern India its range declined from c. 20,000 km2 in the early 1900s to c. 1,000 km2 in the late 1980s. Here we report the results of our recent (1999–2003) assessments of the gazelle's conservation status in Ladakh. Range-wide surveys indicate that the present population of the Tibetan gazelle in Ladakh is c. 50, restricted to a range of c. 100 km2. Populations in the Tso Kar basin and Dungti have gone extinct within the past decade. Throughout the last century hunting was the primary cause of the gazelle's decline. Although hunting has been brought under control in the last two decades, intensified livestock grazing appears to have prevented the gazelle's recovery and may be precipitating further declines. The species needs immediate, participatory conservation management, as well as a reassessment of its IUCN Red List status.