In China, Dolichandrone spathacea is a rare and endangered semi-mangrove plant species with an extremely small population, naturally distributed only in Zhanjiang City and the east coast of Hainan Island. Despite conservation concerns, the population status of D. spathacea has received little scientific attention. In this study, we evaluated the current status of D. spathacea on Hainan Island, China, in order to propose sustainable conservation strategies for future ecological restoration of its natural population. D. spathacea on Hainan Island can be divided into four populations. All the D. spathacea populations present a state of overall dispersion, local concentration, and occasionally sporadic existence, and they exist in geographical isolation. The young, middle, and old D. spathacea plants account for 20.42%, 66.20%, and 13.38%, respectively, indicating that the D. spathacea population on Hainan Island is declining. Furthermore, instead of temporal structure, we used diameter at breast height (DBH) to establish a static life table, draw a population survival curve, and quantify the future development trend through population dynamic analysis and time-series prediction. These results suggest that the D. spathacea population in the Bamen Gulf (Wenchang) and Qingmei Harbor (Sanya) on Hainan Island is sensitive to external disturbances and possesses two main increases in mortality rate—namely, in its juvenile and mature stages—due to competition and anthropogenic interferences, which might be the most important reasons for its endangered status. Depending on the current conditions of the D. spathacea population, we should conserve and expand mature trees in situ, preserve their germplasm resources, rehabilitate their habitats to promote provenance restoration, and conduct artificial cultivation and spreading planting in order to realize the sustainable conservation and management of D. spathacea.