Hawaiian honeycreepers are experiencing a wave of extinctions that may see the loss of most remaining members of this unique family within the decade. The greatest current threat to Hawaiian forest birds is introduced mosquito-borne diseases, notably avian malaria. Honeycreepers are highly susceptible to these diseases, as they evolved in their absence. We present data to show that this crisis is accelerating and discuss management options, including translocation, conservation breeding and in situ measures. New results suggest that climate change is increasing the prevalence of mosquitoes and disease within critical habitat. Recent data also show that several endemic species on Kauai Island have suffered recent population crashes. Most notably, Akikiki (Oreomystis bairdi), declined from 440 in 2018 to fewer than 100 individuals in 2021, and adult survival probability dropped from 0.75 in 2015 to 0.34 in 2020; this species will likely go extinct in the wild by 2023. Akekee (Loxops caerulurostris) numbers several hundred birds and will likely disappear by 2030. There are tools under development to control of mosquitoes and avian malaria, but their earliest possible initial implementation is estimated to in 2024, thus ex situ measures are also on the table. We discuss the need for bold intervention and present some innovative solutions to prevent extinction of these remaining unique species.