Over the next century, the conservation of biodiversity will depend not only on our ability to understand the effect of climate change, but also on our capacity to predict how other factors interact with climate change to influence species viability. We used American ginseng (Panax quinquefolius L.), the United States' premier wild-harvested medicinal, as a model system to ask whether the effect of harvest on extinction risk depends on changing climatic conditions. We performed stochastic projections of viability response to an increase in maximum growing-season temperature of 1°C over the next 70 years by sampling matrices from long-term demographic studies of 12 populations (representing 75 population-years of data). In simulations that included harvest and climate change, extinction risk at the median population size (N = 140) was 65%, far exceeding the additive effects of the two factors (extinction risk = 8% and 6% for harvest and climate change, respectively; quasi-extinction threshold = 20). We performed a life table response experiment (LTRE) to determine underlying causes of the effect of warming and harvest on deterministic λ (λd). Together, these factors decreased λd values primarily by reducing growth of juvenile and small adult plants to the large-adult stage, as well as decreasing stasis of the juveniles and large adults. The interaction observed in stochastic model results followed from a nonlinear increase in extinction risk as the combined impact of harvest and warming consistently reduced λ values below the demographic tipping point of λ = 1. While further research is needed to create specific recommendations, these findings indicate that ginseng harvest regulations should be revised to account for changing climate. Given the possibility of nonlinear response like that reported here, pre-emptive adaptation of management strategies may increase efficacy of biodiversity conservation by allowing behavior modification prior to precipitous population decline.