Fire was arguably the most important forest and rangeland disturbance process in the Inland Northwest United States for millennia. Prior to the Lewis and Clark expedition, fire regimes ranged from high severity with return intervals of one to five centuries, to low severity with fire-free periods lasting three decades or less. Indoamerican burning contributed to the fire ecology of grasslands and lower and mid-montane dry forests, especially where ponderosa pine was the dominant overstory species, but the extent of this contribution is difficult to quantify. Two centuries of settlement, exploitation, management, and climate variation have transformed the fire regimes, vegetation and fuel patterns, and overall functionality of these forests. We present a narrative that portrays conditions beginning at the first contact of Euro-American settlers with Indoamericans of the region and extending to the present. Due in part to its geographic isolation, the Inland Northwest was among the last regions to be discovered by Euro-Americans. In 200 years the region has undergone fur trapping and trading, sheep, cattle, and horse grazing, timber harvesting, mining, road construction, native grassland conversion to agricultural production, urban and rural area development, fire prevention, and fire suppression. We highlight key changes to forest landscape patterns and processes that occurred under these combined influences, discuss implications of the changes, and progress towards restoring sustainability. An adaptive ecosystem management model has been adopted by public land management agencies to remedy current conditions. Ecosystem management is a relatively new concept that emphasizes the integrity and sustainability of land systems rather than outputs from the land. Adaptive management emphasizes the twin notions that incomplete knowledge and high degrees of risk and uncertainty about earth and climate systems will always limit land and resource planning and management decisions, and that management is chiefly a learning and adapting process. We discuss current issues and future options associated with ecosystem management, including the low likelihood of social consensus concerning desired outcomes, the lack of integrated planning, analysis, and decision support tools, and mismatches between existing land management planning processes, Congressional appropriations, and complex management and restoration problems.