The Sungazer (Smaug giganteus) is a threatened lizard species endemic to the Highveld grasslands of South Africa. The species faces risks from habitat loss and fragmentation, and illegal harvesting for traditional medicine and the pet trade. Despite these threats, the current conservation status of the species was poorly validated. We visited 79 Sungazer populations recorded in 1978 to assess population change since the initial surveys, and surveyed an additional 164 sites to better define the distribution and estimate the current population size. We interrogated all known historical trade data of the species. One-third of Sungazer populations have been extirpated over the past 37 years. The distribution includes two allopatric populations, with the smaller Mpumalanga population experiencing a significantly higher decline. The species has an extent of occurrence (EOO) of 34 500 km2, and an area of occupancy (AOO) of 1149 km2. The interpreted distribution is 17 978 km2, and just under 60% remains untransformed grassland. We estimate a population size of 677 000 mature individuals, down 48% from the estimated historical population, prior to commercial agricultural development. A total of 1194 live Sungazers were exported under permit from South Africa between 1985 and 2014, with a significant increase in numbers exported over the last decade. Without any evidence of captive breeding, we believe that these animals are all wild-caught. Based on the AOO, level of decline, fragmentation within the distribution and suspected level of exploitation, we recommend classification of the species as Vulnerable under IUCN Red List Criteria A2acd and B2ab(ii–v). The establishment of a protected area network, genetic research and further investigations into the pet and traditional medicine trades are urgently needed.