The smalltooth sawfish Pristis pectinata is threatened with extinction throughout its range and has been designated as Critically Endangered by the IUCN. In the USA, the species historically ranged from Texas to North Carolina, but mortality in fisheries and habitat loss have reduced the range to primarily southwest Florida. The US population was listed as endangered under the US Endangered Species Act in 2003. At that time, data on the biology and ecology of the species were limited. Research and outreach efforts have since expanded, and the quality and quantity of information has increased such that the US population is now one of the most wellstudied sawfish populations worldwide. Smalltooth sawfish are born in litters of 7−14 individuals at lengths of 64−81 cm stretched total length (STL), reach maturity in 7−11 yr at approximately 340 cm STL for males and 370 cm STL for females, grow to a maximum size of about 500 cm STL, and live an estimated 30 yr in the wild. Smalltooth sawfish are piscivorous and shift from shallow estuarine waters as small juveniles to a broader array of coastal habitats as large juveniles and adults. The species is physiologically resilient to anthropogenic stressors, but preserving habitat and reducing fishing effects remain priorities. Data synthesized in this review have advanced our understanding of smalltooth sawfish life history and habitat needs, as well as the threats that continue to affect the population. Cumulatively, these data support optimism for recovery of the smalltooth sawfish in the USA and potentially beyond, though recovery will still require decades.