Due to its restricted natural range and the fact that Mount Trusmadi does not receive the same high level of protection as Mount Kinabalu, "N. macrophylla" is classified as Critically Endangered on the 2006 IUCN Red List of Threatened Species. This differs slightly from an informal assessment made by botanist Charles Clarke in 1997, who classified the species as Endangered based on the IUCN criteria. Clarke wrote that the species "requires the highest level of protection if it is to persist in the wild into the next century". "N. macrophylla" is threatened by over-collection and damage caused to its habitat by visitors. These activities have already depleted populations of this species on the mountain and it is thought to be the most endangered highland "Nepenthes" of Borneo.