Infection by eastern dwarf mistletoe (Arceuthobium pusillum) modifies needle and branch morphology and hastens white spruce (Picea glauca) mortality. We examined potential causal mechanisms and assessed the impacts of infection-induced alterations to host development and performance across scales ranging from needle hormone contents to bole expansion. Needles on infected branches (IBs) possessed higher total cytokinin (CK) and lower abscisic acid contents than needles on uninfected branches (UBs). IBs exhibited greater xylem growth than same-aged UBs, which is consistent with the promotive effect of CKs on vascular differentiation and organ sink strength. Elevated CK content may also explain the dense secondary and tertiary branching observed at the site of infection, i.e. the formation of ‘witches’ brooms' with significantly lower light capture efficiencies. Observed hormone perturbations were consistent with higher rates of transpiration, lower water use efficiencies (WUEs) and more negative needle carbon isotope ratios observed for IBs. Observed reductions in needle size allowed IBs to compensate for reduced hydraulic conductivity. Severe infections resulted in dramatically decreased diameter growth of the bole. It seems likely that the modifications to host hormone contents by eastern dwarf mistletoe infection led white spruce trees to dedicate a disproportionate fraction of their photoassimilate and other resources to self-shaded branches with low WUE. This would have decreased the potential for fixed carbon accumulation, generating a decline in the whole-tree resource pool. As mistletoe infections grew in size and the number of IBs increased, this burden was manifested as increasingly greater reductions in bole growth.