Mountain summits present a unique challenge to manage sustainably: they are ecologically important and, in many circumstances, under high demand for recreation and tourism activities. This article presents recent advances in the assessment of resource conditions and visitor disturbance in mountain summit environments, by drawing on examples from a multiyear, interdisciplinary study of summits in the northeastern United States. Primary impact issues as a consequence of visitor use, such as informal trail formation, vegetation disturbance, and soil loss, were addressed via the adaption of protocols from recreation ecology studies to summit environments. In addition, new methodologies were developed that provide measurement sensitivity to change previously unavailable through standard recreation monitoring protocols. Although currently limited in application to the northeastern US summit environments, the methods presented show promise for widespread application wherever summits are in demand for visitor activities.