Rare species population dynamics can elucidate the resilience of an ecosystem. On coral reefs, climate change and local anthropogenic stressors are threatening stony coral persistence, increasing the need to assess vulnerable species locally. Here, we monitored the threatened pillar coral, Dendrogyra cylindrus, population in southeast Florida, USA, in relation to consecutive heat stress events in 2014 and 2015. In the fall of each year, D. cylindrus colonies bleached following intense thermal stress and by June 2020 all monitored colonies died from a white-syndrome type disease. This resulted in the ecological extinction of D. cylindrus in the Southeast Florida Coral Reef Ecosystem Conservation Area (ECA). White-syndrome type disease was first seen in February 2014 on four colonies (19% prevalence) near the major international port, Port Everglades and disease prevalence peaked in fall 2015 (58%). Disease prevalence increased with maximum water temperature, while disease related mortality increased with mean water temperature. Our findings suggest that thermal stress exacerbated underlying stony coral disease, resulting in an outbreak contributing to the ecological extirpation of D. cylindrus in the ECA. We suggest that stony coral resilience is severely compromised by chronic environmental disturbance which hinders community recovery.