The Great Slaty Woodpecker ( Mulleripicus pulverulentus) of South and Southeast Asia, the third largest woodpecker species in the world, is currently in the IUCN Red List category of Least Concern. This woodpecker appears associated with old-growth forests, and the rapid reductions in forest cover and old-growth area in Southeast Asia urged examination of its global population trends. We assessed population densities, tree diameter use by the woodpecker, and logging disturbance at 21 transects in four regions across the range of the species: west Borneo, Lingga Island (Riau Archipelago, Indonesia), Tenasserim (Myanmar), and west-central Myanmar. Transect survey effort was 937 km. We assessed rates of deforestation and loss of old-growth forest in the range of the species from expert review reports. By combining population density and forest cover data sets we calculated the global population trend of the species. We found a preference for large diameter trees by foraging and nesting Great Slaty Woodpeckers, and a reduction of the frequency of such trees in logged forests. Across the four study regions, between old-growth forests and logged forests, densities of Great Slaty Woodpeckers were reduced by 80–94%. Although Great Slaty Woodpeckers occur in 15 countries, ca. 70% of the global population occurs in just four countries (Myanmar, Indonesia, Cambodia, and Malaysia), three of which have high annual rates of deforestation and loss of old-growth forest. Our population calculations show that over the past century at least 90% of the global population of the Great Slaty Woodpecker has been lost. At present 26,000–550,000 individuals remain. The current global decline rate of ca. 59% ± SD 17% in three generations justifies IUCN Vulnerable or Endangered status. Contributing factors to the steep decline rate of the species are a long generation time of 5.9–8.2 years and an association with old-growth, lower elevation forests. The Great Slaty Woodpecker case adds an Asian example to a global pattern of specialized woodpeckers that are associated with old or natural forests.