East of the Mississippi River, Florida has the highest cactus diversity in the US. The Atlas of Florida Plants currently recognizes 14 native taxa and all but one species are listed as threatened or endangered by the State of Florida. To date, the biggest threat to Florida’s native cacti is development. However, many of these cactus species are growing in coastal habitats which also makes them particularly vulnerable to sea level rise. This second threat became especially obvious in 2021 when the last known wild individual of one species (Pilosocereus millsphaughii) had to be rescued by Fairchild and partners. Although the cactus previously showed signs of herbivory by potentially rodents, the base of the plant was heavily damaged by recent storm surges and king tides, making it possibly the first species in the US to be extirpated due to sea level rise. To conserve the remaining cactus populations in southeast Florida, Fairchild and partners have a multifaceted program that includes field surveys, ex situ conservation, reintroductions, and seed banking. Additional work at Fairchild, conducted with the help of college interns and high school students, has included hand pollination and researching the effects of salinity levels on seed germination. Currently the best option for some of these species is reintroduction to higher ground within their natural range, but questions remain about the long-term strategy for these charismatic plants.