Drought and warming increasingly are causing widespread tree die-offs and extreme wildfires. Forest managers are struggling to improve anticipatory forest management practices given more frequent, extensive, and severe wildfire and tree die-off events triggered by “hotter drought”—drought under warmer than historical conditions. Of even greater concern is the increasing probability of multi-year droughts, or “megadroughts”—persistent droughts that span years to decades, and that under a still-warming climate, will also be hotter than historical norms. Megadroughts under warmer temperatures are disconcerting because of their potential to trigger more severe forest die-off, fire cycles, pathogens, and insect outbreaks. In this Perspective, we identify potential anticipatory and/or concurrent options for non-timber forest management actions under megadrought, which by necessity are focused more at finer spatial scales such as the stand level using higher-intensity management. These management actions build on silvicultural practices focused on growth and yield (but not harvest). Current management options that can be focused at finer scales include key silvicultural practices: selective thinning; use of carefully selected forward-thinking seed mixes; site contouring; vegetation and pest management; soil erosion control; and fire management. For the extreme challenges posed by megadroughts, management will necessarily focus even more on finer-scale, higher-intensity actions for priority locations such as fostering stand refugia; assisted stand recovery via soil amendments; enhanced root development; deep soil water retention; and shallow water impoundments. Drought-induced forest die-off from megadrought likely will lead to fundamental changes in the structure, function, and composition of forest stands and the ecosystem services they provide.