In Northern Europe, climate change may facilitate the prevalence of Scots pine, yet also promote the spread of pathogens attacking this species. A common biotic risk for Scots pine in nurseries and young stands is Lophodermium needle cast, primarily caused by Lophodermium seditiosum, which negatively affects the survival and growth of saplings. Reduced tree growth has been observed several years after damage by Lophodermium needle cast. However, for decision-making in protection or resistance breeding, an estimate of financial loss is important. Thus, the study aimed to assess the long-term influence of Lophodermium needle cast on the growth and financial value of Scots pine stands. The effect of needle cast damage during the sixth growing season on growth at the age of 17 years was evaluated in a control-crossed Scots pine progeny trial, and the results indicated a significantly negative effect on the height and diameter of the trees. A significant family effect also existed on the severity of the needle cast damage. Long-term simulations indicated that severely damaged Scots pines had a reduced equivalent annual annuity (EAA) of almost 100% at the final harvest. More intensive early management to reduce stand density could partly compensate for losses caused by needle cast. A higher EAA for the most resistant group of trees regardless of the stand management scenarios suggests an economically justified potential for improved resistance. Strong negative (−0.62 to −0.70) correlations of height and survival with the proportion of severely affected trees at the family mean level implies that resistant genotypes can be selected along with improved growth in progeny trials, which are affected by needle cast.