Habitat degradation and human persecution are the principle threats to Hexaprotodon liberiensis.
Hexaprotodon liberiensis occurs in four countries (Guinea, Sierra Leone, Liberia and Ivory Coast), and it is everywhere decreasing, with the possible exception of Guinea. Captive breeding could play a relevant role in the long-term conservation of the species. However, despite seventy years of breeding history, the husbandry of the pygmy hippo needs to be enhanced to maintain the species in more appropriate physical and social conditions.
The pygmy hippopotamus Hexaprotodon liberiensis is considered "Vulnerable" by the 1996 IUCN Red List of Threatened Animals.
Hexaprotodon liberiensis is an endemic and endangered species of the Upper Guinean forest, a region recognized as both an EBA (Endemic Bird Area) and a 'hotspot' for plant biodiversity conservation. Therefore this taxon could serve as a flagship species for one of the most rich and threatened biota on earth.