In the context of climate change, the effects of prolonged or more severe droughts on pest and pathogen damage are a major concern for forest ecosystems. To date, there is great uncertainty about the direction, magnitude and sources of variation in responses to drought by insects and fungi. We report the outcomes of a meta-analysis of 100 pairwise comparisons of insect pest or pathogen damage to water-stressed and control trees from 40 publications. The type of feeding substrate for insects and fungi and the water stress severity emerged as the main factors influencing the level of damage in water-stressed trees. Overall, primary damaging agents living in wood caused significantly lower damage to the water-stressed trees compared with the control, whereas primary pests and pathogens living on foliage caused more damage to water-stressed trees, in all cases irrespective of stress severity. In contrast, damage by secondary agents increased with stress severity, which was best estimated by the ratio between the predawn leaf water potential in stressed trees and the xylem pressure inducing 50% loss in hydraulic conductance due to cavitation, a species-specific index of drought tolerance. Insect and fungus feeding behaviour, affected tree part, and water stress severity are therefore proposed as three important predictors of forest damage in drought conditions.