Disturbance is a central process in forest dynamics, yet the role of natural disturbance in tropical montane forests (TMFs) has not been systematically addressed. We posit that disturbance in TMFs has a wider role than commonly acknowledged and its effects are distinctive because: (1) TMFs often have very low rates of productivity due to low resources, and so recovery from disturbance may be slow, (2) montane forests have marked environmental heterogeneity which interacts with disturbance, (3) a large percentage of TMFs are regularly exposed to high energy windstorms and landslides, and (4) TMFs contain a biogeographically rich mixture of tree species with divergent evolutionary histories that interact differently with different disturbance types. We reviewed the literature on natural disturbance in TMFs and found 119 peer-reviewed papers which met our search criteria. Our review shows that disturbance is widespread in TMFs with pronounced effects on structure, function, composition and dynamics. Disturbance is also evident in the ecology of TMF biota with clear examples of plant life-history traits adapted to disturbance, including disturbance-triggered germination, treefall gap strategies and resprouting ability. Important aspects of TMF disturbances are stochastic and site-specific, but there are broad patterns in disturbance type, frequency and severity along latitudinal, altitudinal and environmental gradients. Compared with the lowland tropics, TMF disturbances are more spatially structured, TMFs experience more disturbance types in a given area due to environmental complexity, and TMFs are much more prone to small-scale yet severe landslides as well the large and potentially catastrophic disturbances of cyclones, forest die-back and fire. On the whole, natural disturbance should assume a larger role in models of ecosystem processes and vegetation patterns in TMFs. An improved understanding of what creates variation in disturbance severity and post-disturbance recovery rates, how composition and diversity feedback on disturbance type and likelihood, and how global change will alter these dynamics are important priorities in future TMF ecology research.