Sea turtle conservation is often hindered by the lack of reliable information on population status and threats due to sampling difficulties of these highly migratory reptiles that live in remote and data-poor locations. This paper summarizes more than a decade of stranding recoveries (live and dead turtles) on the islands of Saipan and Tinian, Commonwealth of the Northern Mariana Islands (CNMI), to obtain baseline information on the primary threats to sea turtles in the CNMI. Gross external examination and necropsy of dead turtles was used to infer primary cause of stranding of 89 sea turtles (92.1% green (Chelonia mydas), 5.6% hawksbill (Eretmochelys imbricata), 1.1% olive ridley (Lepidochelys olivacea), and 1% unknown). Of these stranding recoveries, 80.9% were juveniles, 15.7% were adults, and 3.4% were unknown. Trauma related to illegal human take was the primary cause of stranding and accounted for 79% of CNMI sea turtle injuries and mortalities. The remaining 21% of strandings were attributed to (in rank order): marine debris entanglement, shark bite, boat strike, emaciation, and infectious disease. This study provides the first comprehensive characterization of cause-specific sea turtle injury and mortality in CNMI, described within the unique socio-cultural and historical dynamics of the region. Culturally-relevant suggestions for management are provided that may help address the primary threat to CNMI sea turtles.