The Neotropical realm hosts some of the Earth’s most species-rich biodiversity hotspots, with vascular epiphytes significantly contributing to this diversity, regionally accounting for up to 39% of the vascular flora. However, many regions of the Neotropics where epiphytic species of restricted distribution are reported coincide with threatened ecosystems, such as the tropical montane cloud forest. Moreover, epiphytes may be especially vulnerable to land use and climate change impacts due to their dependence on host trees. We assessed the conservation status of vascular epiphytes in the Neotropics for the families that represent over 80% of the global epiphyte diversity (Araceae, Bromeliaceae, Orchidaceae, Piperaceae, and Polypodiaceae) and identified geographical centres of accumulation of threatened epiphyte species. We gathered information from free-access web repositories, specific epiphytic plant databases, and scientific and grey literature. We assessed the extinction risk of 11,446 epiphyte species following IUCN Red List guidelines, using Criterion B (geographic range size). We found nearly 60% (6,721 species) to be threatened, with 1,766 critically endangered (CR), 3,537 endangered (EN), and 1,418 vulnerable (VU). The threatened species are mainly found in the centres of endemism of vascular epiphytes in Central America, the northern Andes, and the Atlantic Forest. Our study emphasises that the centres of threatened species largely coincide with diversity hotspots, highlighting epiphytes as an especially vulnerable group that requires urgent conservation actions.