The populations of many endangered species are becoming increasingly fragmented, and accurate, current information on the status of these subpopulations is essential for the design of effective conservation strategies within a human-dominated landscape. The drill (Mandrillus leucophaeus) is one of the most spectacular and endangered primates in Africa, yet up-to-date information on its distribution, population status, and conservation outlook is lacking. Cameroon has been estimated to encompass 80 % of the species’ range. We examined the distribution, population status, and conservation outlook for the drill throughout its historic range in Cameroon. To do this, we divided the historic range of the drill in Cameroon (46,000 km2) into 52 survey units along natural and manmade boundary features. Based on a series of field surveys in 2002–2009, village interviews, analysis of geospatial data, and bibliographical research, we assigned each survey unit a rank of 0–4 for 15 parameters indicative of current situation for drills, habitat suitability, and conservation outlook. We obtained direct evidence for the presence of drills in 16 of the 52 survey units, with those of Ejagham, Korup, Ebo, and Nta Ali receiving the highest index scores. We warn of local extirpations and increased isolation among drill populations due to loss of dispersal corridors, e.g., Douala Edea survey unit. In some cases drills persist in forest fragments within human-dominated landscapes, e.g., Kupe-Manenguba, but the species’ future is probably dependent on effective wildlife management in a handful of isolated strongholds where probability of long-term protection is higher, particularly in Korup National Park, Takamanda National Park, and the proposed Ebo National Park. Pressure from current and proposed large-scale commercial plantations, oil prospecting, logging, and the continual human population growth in this region means that a concerted conservation effort will be needed to safeguard the remaining drill habitat if the species is to survive in Cameroon.