Along with other amphibian populations in Europe and elsewhere, natterjack toad Bufo calamita populations in Britain have declined since at least 1960. Conservation management since the 1970s has aimed to halt the decline and maintain viable populations at key sites throughout the species' recent historical range. Here, we assess population trends from 1985 to 2006 at 20 British B. calamita sites and evaluate the role of active management in maintaining good conservation status. We investigated the effects of 25 climatic, site-characteristic and conservation management variables on population trends using general linear models. In single-variable analyses, rainfall variables showed negative relationships with population trends. Among the site characteristics, being located at the very edge of the species' range (northern Irish Sea coast) and occurrence of common toad (B. bufo) were negatively related to B. calamita population trends. Management history (populations established via translocation as opposed to native populations) had a significant positive effect; as had sites that received greater translocation releases, undergone Species Recovery Programme management, and where common toad was absent. In multiple-variable analyses, the combined effects of management history and average pre-breeding season rainfall accounted for inter-site variation in population trends. The rainfall effects in single- and multiple-variable analyses were strongly influenced by three sites with very high rainfall whilst no clear effect was apparent for the remaining sites. This study highlights the role of climatic factors in population decline, and the importance of conservation management in stabilizing population trends. Climate change over the next 50–100 years is predicted to have limited impacts on most B. calamita populations in Britain, but strongly positive impacts on the most threatened populations located at the very edge of species' range that will benefit from reduced precipitation. A need for active conservation management will remain for the foreseeable future.