Malus sieversii (Ledeb.) M. Roem is a tertiary relict tree species and a rare and valuable resource for germplasm conservation. Since 1995, its wild forest has been severely destroyed by a devastating wood-boring beetle Agrilus mali Matsumura (Coleoptera: Buprestidae) in Xinjiang Uygur Autonomous Region, China. Where it invaded, this beetle infested more than 95% of the forests, and 80% of wild apple trees were reported dead in the hotspots. The physiological damage by A. mali infestation and their causality to tree death remain unclear. In this study, we attempted to explain the wild apple dieback from plant physiological perspectives, based on the hypothesis that the more damage M. sieversii suffered from the infestation of A. mali, the less water and fewer nutrients it could utilize. The study was conducted on trees with different extents of damage in wild apple forests over a large scale during 2016 and 2017. The stable carbon isotope ratio in leaves was analyzed to indicate tree water stress status. Total N, total P, total K, Ca2+ and Mg2+ were analyzed to reflect plant mineral nutrient status. The extent of damage was significantly associated with the leaf stable carbon isotope ratio in the drier year of 2016, but not significantly in 2017 with heavy rainfall in spring. The mineral nutrient contents of leaves were not significantly different among the four damage rankings in either year. The water stress experienced by M. sieversii was aggravated by the damage caused by A. mali, especially in a drought year, and indicates that the long-term water deficit caused by A. mali infestation may be the key factor leading to the decline of wild apple forests. The finding suggests the necessity of aerial irrigation for sustainable integrated pest management in wild apple trees.