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Habitat degradation and loss are severely affecting macroalgal forests worldwide, and their successful mitigation depends on the identification of the drivers of loss and the implementation of effective conservation and restoration actions. We made an extensive literature review 1- to document the historical (1789–1999) and recent (2000−2020) occurrence of the genus Cystoseira, Ericaria and Gongolaria reported in the literature along the 8000 km of the coasts of Italy, 2- to assess their decline and patterns of extinction, 3- to ascertain the drivers responsible for these changes, 4- to highlight the existence of success stories in their conservation and natural recovery. In the last twenty years, overall information on the distribution of Cystoseira s.l. exponentially increased, although research focused almost exclusively on intertidal reefs. Despite the lack of systematic monitoring programs, the local extinction of 371 populations of 19 different species of Cystoseira s.l. was documented across several regions, since 2000. Coastal engineering and poor quality of waters due to urban, agricultural or industrial activities were often documented as leading causes of habitat loss. However, the drivers of extinction were actually unknown for the majority of the populations and cause-effects relationships are scarcely documented. Although the proportion of protected populations increased to 77.8%, Marine Protected Areas are unlikely to guarantee adequate conservation efficacy, possibly also for the widespread lack of management and monitoring plans dealing specifically with Cystoseira s.l. species, and few evidences of natural recovery were observed. Our review shows the dramatic lack of baseline information for macroalgal forests, highlighting the urgent need for the monitoring of less accessible habitats, the collection of long-term data to unveil drivers of loss, and an updated reporting about the conservation status of the species of interest to plan future interventions.