A revision of the species in the genus Pityophthorus Eichhoff in North and Central America is presented. The limits of Pityophthorus are expanded to include the species previously placed in Gnatholeptus Blackman. This unit is maintained as a subgenus. One additional subgenus is described, Hypopityophthorus, for P. debilis Wood and P. inops Wood. The genus contains 220 species in North and Central America. The principal subgenus Pityophthorus is divided into 47 species groups. New species are: micans (Mexico), sapineus (Mexico), miniatus (Honduras, Guatemala, and Mexico), pubifrons (Mexico), and acceptus (British Columbia, Wyoming). New synonymy is proposed as follows: P. deletus LeConte (= P. dolus Wood); P. exquisitus (Blackman) n. comb. (= P. inceptis Wood); P. intextus (= P. ornatus Blackman and P. limatus Wood); P. balsameus Blackman (= P. angustus Blackman) and P. indigens Wood (= P. irritans Schedl). Five species are given new status as subspecies: P. tuberculatus Eichhoff as a subsp. of P. pulchellus Eichhoff; P. subopacus Blackman as a subsp. of P. segnis Blackman; P. bellus Blackman as a subsp. of P. confusus Blandford; P. agnatus Blackman as a subsp. of P. confertus Swaine, and P. aurulentus Bright as a subsp. of P. murrayanae Blackman.The monograph includes an historical review, a discussion of diagnostic characters, and a discussion of the general biology of species in the genus. Keys to subgenera, species groups, and species are provided. Each species is described and many are illustrated, and all known bionomic and distributional data are included. Distribution records of many species are mapped.