The American beech (Fagus grandifolia Ehrh.) has been impacted by the beech bark disease (BBD) complex throughout the northeastern United States for over 100 years, but the disease has been present in the Great Lakes region only for around 20 years, requiring acknowledgement of the evolving context surrounding F. grandifolia. This disease threatens to remove a foundational tree species which is especially important ecologically for wildlife habitat and mast, and as a climax successional species. We review advances in propagation techniques of F. grandifolia with the goal of addressing their use in the rehabilitative restoration of forests affected by BBD. Natural regeneration and artificial methods of propagation are addressed, along with how they may be applied for mitigation. Silvicultural interventions are discussed that may be necessary to protect and release resistant seedlings to promote persistence. An existing framework is used to explore context necessary for decision making in restoration. Nucleated seed orchards of resistant trees may currently be the most effective and practical method for introduction of BBD-resistant F. grandifolia into affected northern hardwood forests.