Pterocarpus angolensis (kiaat) is a well-known southern African tree species of commercial importance that occurs in several vegetation types in the Zambezian regional centre of endemism. The most prominent of these vegetation types are the Zambezian miombo woodland and undifferentiated woodland. A diverse range of ecosystems within these vegetation types necessitate adaptation by tree species to survive extremes of drought, temperature, altitude, soil nutrition and tolerate fire in order to compete with other plant species. There are several reports of a die-back disease of P. angolensis in Zambia, Zimbabwe and South Africa, but very little is known regarding the cause or significance of this problem. In this review, we provide details regarding the history of the disease and consider its possible causal agents. A pathology study conducted at three locations in South Africa on diseased and dying trees resulted in the collection of 199 fungal isolates; comprising saprophytic species such as Candida, Penicillium and Humicola, and potentially pathogenic species such as Lasiodiplodia theobromae, Cytospora spp. and Fusarium spp. Drought, during several years preceding disease, along with a lack of fire management may have contributed to both the present and past reports of tree die-back and death. Finally, an analysis is made of the importance of the problem and actions that might be taken to alleviate it.