Since the introduction prior to 1915 of white pine blister rust (Cronartium ribicola) into the forests of western North America, many populations of native white pine species have seriously declined. Because western white pine (Pinus monticola) and sugar pine (P. lambertiana) are highly valued timber species, their silviculture under intensive management is well-documented. The silviculture of other white pine species has received less attention but is no less important. For all western species, silvicultural management is a key component for sustaining and restoring viable white pine populations. This review examines approaches for assessing and reducing blister rust hazard, regenerating white pine stands, and tending established stands to reduce damage and impact from blister rust. Hazard and risk ratings provide means for assessing the potential severity of blister rust infestation and its probable impacts on management. An epidemiological simulation model is available for describing complex pathosystem interactions, their consequences on white pine growth and survival, and likely outcomes of silvicultural activities. Until the 1960s, Ribes eradication was the principal method for blister rust control; it is now rarely used except for high-value trees. The choices of harvest and site preparation methods are critical for successful white pine regeneration. As host responses to blister rust infection are inherited, regeneration is an opportunity to increase seedling survival and disease resistance. For artificial regeneration, the western genetics programmes provide improved planting stock. For natural regeneration, the selection and retention of well-adapted white pines as seed sources can enhance stand genetics. Thinning and pruning are common silvicultural activities for tending stands and are readily modified for blister rust-infested stands. Although biological and chemical agents have been used, their performance has been less than satisfactory. Likewise, genetics and other silvicultural practices have also demonstrated limited success in blister rust control. An alternative, adaptive approach could use both silvicultural and genetic techniques to mitigate impacts and maintain white pines.