Polystachya orophila is an orchid exclusively known from montane savannah on rocky outcrops rising from the surrounding savannah, where it grows as a lithophyte, although it can also be found as an epiphyte growing on root clusters of Afrotrilepis pilosa, which provides protection from fire. The species is endemic to West Africa, known from Guinea (Nimba Mountains and the Simandou range) and the Loma Mountains in Sierra Leone. It occurs from an elevation of 900 m on Nimba to the summit of Mount Bintumane in the Loma Mountains at 1,800 m. It is known from 34 collections made between 1909 and 2017. However, we excluded seven historical collections made in the Nimba Mountains due to imprecise coordinates. The 27 remaining collections represent 19 occurrences and three subpopulations. Based on a 2 × 2 km grid cell size, the area of occupancy (AOO) is estimated at 28 km², below the upper threshold for Endangered under subcriterion B2, and its extent of occurrence (EOO) has been calculated as 9,992 km², below the upper threshold for  Vulnerable under subcriterion B1. The species is known from three protected areas: the Loma Mountains National Park, the Mount Nimba Strict Nature Reserve, and the Pic de Fon Classified Forest (Simandou range). However, the occurrence made within the Pic de Fon Classified Forest is located within a mining concession. Moreover, the species is known from another mining concession located in the Nimba Mountains. Since the species is resistant to the frequent human-induced fire events that regularly affect the sites where it occurs, the main threat it may face is habitat destruction due to road construction associated with the ongoing exploration phase of mining projects at both Simandou and Nimba. As a consequence, the 19 occurrences represent four locations (sensu IUCN 2019) with regard to the most serious plausible threat (mining activities). Moreover, a decision to proceed with the planned mining activities would significantly increase the scope and intensity of impacts at both sites, thereby resulting in a higher level of threat. While a decision to begin exploitation is currently on hold at both sites, such projected exploitation would result in loss of its habitat, which leads us to infer a continuing decline in the extent and the quality of its habitat, as well as the number of locations, the number of mature individuals, and thus, also of its AOO and EOO. There is limited population information available for this species, and so an assessment cannot be made under criteria A, C or D. This species is thus assessed as EN B2ab(i,ii,iii,iv,v).

Polystachya orophila is endemic to West Africa, known from the Nimba Mountains and the Simandou range in Guinea and the Loma Mountains in Sierra Leone. It occurs from an elevation of 900 m on Nimba to the summit of Mount Bintumane in the Loma Mountains at 1,800 m. It is known from 34 collections made between 1909 and 2017. Since the Nimba range spans three countries, Guinea, Côte d'Ivoire and Liberia, it is expected to also occur in the latter two countries.

No quantitative population data are available for this species.

Polystachya orophila is exclusively known from montane savanna on rocky outcrops rising from the surrounding savanna, where it grows as a lithophyte, although it can also be found as an epiphyte growing on root clusters of Afrotrilepis pilosa, which provides protection from fire.

Since the species is resistant to the frequent human-induced fire events that regularly affect the sites where it occurs, the main threat it may face is habitat destruction due to road construction associated with the ongoing exploration phase of mining projects at both Simandou and Nimba. Moreover, a decision to proceed with the planned mining activities would significantly increase the scope and intensity of impacts at both sites, thereby resulting in a higher level of threat. While a decision to begin exploitation is currently on hold at both sites, such projected exploitation would result in loss of its habitat, which leads us to predict a continuous decline in the quality of its habitat, as well as of the number of subpopulations and mature individuals, and thus, also of its AOO and EOO.

There are no known uses of this species.

Polystachya orophila is known from two protected areas: the Loma Mountains National Park, and the Mount Nimba Strict Nature Reserve where occurrences are not threatened. However, since the species is threatened by mining activities, various conservation measures should be considered. First, it should be sought in other places, such as the Mount Nimba Strict Nature Reserve, in Liberia and Côte d'Ivoire, to increase knowledge of its full distribution and specific investigations in Monts Loma in Sierra Leone, where the species has not been recorded since 1944, should be made to confirm its presence and assess its population. Second, it should be regarded as an HCV1 species (High Conservation Value), and as a consequence should be included in the management plan of the industrial concessions within which it occurs. Third, it should be included in the lists of protected species of Guinea and Sierra Leone, and the degradation or loss of its habitat must therefore be avoided. Fourth, ex situ conservation should be tested, both within Guinea and Sierra Leone and internationally. Finally, a public awareness campaign must be conducted targeting industrial companies and other private actors, NGOs, scientific institutions, and governments to ensure that P. orophila is taken into consideration when decisions are made that could impact its conservation.

The species is included in CITES Appended II.