Their breeding habitat is subtropical, evergreen broad-leaved forest that is at least 30 years old on Okinawa Island, with tall trees of more than 20 cm in diameter.

It has a single tiny, declining population which is threatened by habitat loss of mature forest due to logging, dam construction, agriculture, military and golf course developments.

This species is suspected to be declining at a rate of 10-19% over ten years, as a result of ongoing clearance of old-growth forests.

It occurs in Yonaha-dake Prefecture Protection Area and small protected areas on Mount Ibu and Mount Nishime and conservation organisations have purchased sites where it occurs, but it is mainly found in the Okinawa Prefecture.

The habitat of the Okinawa woodpecker is threatened by the construction of six new American helipads[4][5] located about 9.5 km Southwest of the Yanbaru forest of Takae.