Honey bees are important pollinators that support food security and nature’s biodiversity. They are also a source of various honey bee-derived products (api-products) used in the food, pharmaceutical, and cosmetic industries. However, various biological, chemical and physical factors threaten the population and biodiversity of feral and managed honey bees. These challenges have not been elaborated upon in the Pakistani context; therefore, this review aims to identify and describe the menaces to feral and domesticated populations of honey bees in Pakistan. Four honey bee species are reported in the country, with the Western honey bee (Apis mellifera) currently being the main domesticated species. Climate change and urbanization are altering the habitats of honey bees. Additionally, agrochemicals are extensively used to manage emerging pests, exacerbating environmental pollution. The air quality in the majority of urban areas is toxic for honey bees. Although remote forest areas can provide habitat and food for these insects, low forest cover and non-sustainable silviculture are still significant hurdles. Microplastics and antimicrobials are impacting the fitness of honey bees and also appear in their products, making it a One-Health issue. Electromagnetic signals also influence honey bee health and behavior. Overall, all these factors influence honey bee health and colony fitness, ultimately causing population declines in both managed and wild honey bees. The purpose of this information is to assist decision-makers, researchers, beekeepers and educators in comprehending the obstacles faced by the honey bee population within the context of Pakistan.