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Macroalgal forests play a key role in shallow temperate rocky reefs worldwide, supporting communities with high productivity and providing several ecosystem services. Sea urchin grazing has been increasingly influencing spatial and temporal variation in algae distributions and it has become the main cause for the loss of these habitats in many coastal areas, causing a phase shift from macroalgae habitats to barren grounds. The low productive barrens often establish as alternative stable states and only a major reduction in sea urchin density can trigger the recovery of macroalgal forests. The present study aims to assess if the 2018 disease outbreak, responsible for a strong reduction in the sea urchin Diadema africanum densities in Madeira Island, was able to trigger a reverse shift from barren grounds into macroalgae-dominated state. By assessing the diversity and abundance of benthic sessile organisms, macroinvertebrates and fishes before, during and after that particular mass mortality event, we evaluate changes in benthic assemblages and relate them to variations in grazer and herbivore densities. Our results revealed a clear shift from barren state to a macroalgae habitat, with barrens characterized by bare substrate, sessile invertebrate and Crustose Coralline Algae (CCA) disappearing after the mortality event. Overall variations in benthic assemblages was best explained by four taxa (among grazers and herbivores species). However, it was the 2018 demise of D. africanum and its density reduction that most contributed to the reverse shift from a long stable barren state to a richer benthic assemblage with higher abundance of macroalgae. Despite this recent increase in macroalgae dominated habitats, their stability and persistence in Madeira Island is fragile, since it was triggered by an unpredictable disease outbreak and depends on how D. africanum populations will recover. With no control mechanisms, local urchin populations can easily reach the tipping point needed to promote a new shift into barren states. New conservation measures and active restoration are likely required to maintain and promote the local stability of macroalgal forests.