Polystachya rhodochila is endemic to Madagascar and is known from 41 collections representing 27 occurrences. Ten collections representing nine occurrences have been recorded in five protected areas, the Tsaratanana Natural Reserve (two occurrences, one location), the Marojejy-Anjanaharibe Sud-Tsaratanana Corridor (COMATSA) (one occurrence, one location), the Analamazaotra National Park (three occurrences, one location), the Mantadia National Park (two occurrences, one location) and the Torortorofotsy Protected Area (one occurrence, one location). In addition to these officially protected sites, 25 collections representing 12 occurrences of this species have also been made on the footprint of a mining project undergoing intense human pressure such as forest clearing. These occurrences should be considered as extirpated due to the forest clearing by mining project activities. Four collections representing four occurrences of this species have been made in the Conservation Zone surrounding the footprint of the mining project. This Conservation Zone should be subjected to protection in the near future. It is also known from two collections representing two occurrences made from Maintirano (one occurrence, one location) and Ankaizinana (one occurrence, one location) made in unprotected forest subjected to urbanization, selective logging, timber harvesting for small-scale subsistence, and slash-and-burn practices (tavy). One of these occurrences (Herb. 1220) was collected from individual that has since also been extirpated due to the urbanization zone of Maintirano. The species is thus known from 41 collections representing 14 existing and 13 extirpated occurrences.

The extent of occurrence (EOO) of P. rhodochila is estimated to be 20,897 km² (exceeding the limits for Vulnerable status under criterion B1) and its minimal area of occupancy (AOO) is estimated to be 44 km² (which falls within the limits for Endangered status under the criterion B2). These 14 remaining occurrences represent a total of seven locations (sensu IUCN 2019) with respect to the main threat, mining activities, falling within the limit for Vulnerable status. The loss of the subpopulation in the footprint of a mining project and urbanization zone of Maintirano have induced a continuous decline of the EOO, the AOO, the number of subpopulations, locations, and the number of mature individuals. Polystachya rhodochila is therefore assessed as Vulnerable; VU B2ab(i,ii,iii,iv,v).

Polystachya rhodochila is endemic to Madagascar where it occurs in the former provinces of Antsiranana in the Diana Region (Tsaratanana, Ankiakabe COMATSA), of Mahajanga in the Sofia Region (Ankaizinana, Maintirano) and of Toamasina in the Alaotra-Mangoro Region (Analamazaotra, Mantadia, Ampitambe-Moramanga, Torotorofotsy). The species is known from the eastern escarpment, the High Plateau, and the western dry forests.

The population of Polystachya rhodochila is currently thought to be decreasing since the species habitat is threatened by forest clearing due to mining activities, and forest degradation by slash-and-burn practices (tavy), selective logging, timber harvesting for small-scale subsistence, urbanization. The number of individuals of P. rhodochila is not known and cannot be estimated since the species is an epiphyte herb growing on trunks and on moss and lichen covered trees.

Polystachya rhodochila is an epiphytic herb growing on the trunks of trees and on moss and lichen covering trees in humid and subhumid forests at elevations of 13 to 2,000 m asl (Madagascar Catalogue 2020).

The species is threatened by shifting agriculture and selective logging. Twelve occurrences of this species have been collected on the footprint of a mining project undergoing intense human pressure such as forests clearing. It is also known from two occurrences in unprotected forests subject to selective logging, timber harvesting for small-scale subsistence, and slash-and-burn practices (tavy). One of these was collected from an individual that have since also been extirpated due to urbanization zone of Maintirano.

There are no reported uses of this species, but it may be sought after by specialist collectors.

Polystachya rhodochila has been recorded from five protected areas, the Tsaratanana Natural Reserve (two occurrences), Marojejy-Anjanaharibe Sud-Tsaratanana Corridor (COMATSA) (one occurrence), Analamazaotra National Park (three occurrences), Mantadia National Park (two occurrences), and Torortorofotsy Protected Area (one occurrence). Four occurrences of this species have also been made in the conservation zone surrounding the footprint of a mining project undergoing intense human pressure such as forests clearing. This conservation zone should be subjected to protection in the near future. The species is included in Appendix II of CITES. It is recorded in one ex situ collection (BGCI 2020). Several individuals of this species have been brought to cultivation in the Ambatovy shade houses. Ex situ conservation is recommended (micro-propagation, seed banking). Further awareness building is recommended for local communities and national authorities.