Musk deer (Moschus spp.) are widely known for its musk and are globally endangered as a result of poaching, habitat loss, and fragmentation. To facilitate restoration of the alpine musk deer (M. chrysogaster) in existing areas, reliable estimates of population size and influencing factors are essential to assess effectiveness of conservation interventions, particularly for isolated musk deer populations in patches. In this paper, we used line transect and camera trap data collected from 2020 to 2022 in the Helan mountains to assess the population status and characterized the influencing factors of alpine musk deer. Our findings indicate that musk deer are patchily distributed in three areas of high elevation, with the population limited to less than 200 individuals, remaining below historic levels (compared to 1995). There was a significant positive correlation between the role of sympatric species on musk deer, with red fox (Vulpes vulpes), badger (Meles meles) and blue eared-pheasant (Crossoptilon auritum) having a significant effect on the out-modeled pathway. Variable but insignificant effects of anthropogenic activities were observed across all species categories, which could be due to mutual adaptation over time. Our results imply that the recovery of sensitive population in island-like habitats remains challenging and may be exacerbated by limited environment and resources. Our study underscores the necessity of establishing ecological corridors to enhance habitat connectivity for alpine musk deer, undertaking conservation genetics research on isolated populations, controlling stray dogs to maintain interspecific balance, and implementing electronic fencing to mitigate human disturbance and resource competition. This study provides basic information for understanding the population status of alpine musk deer and offers insights for conservation efforts.