The Asian elephant (Elephas maximus) population in Nangunhe National Nature Reserve in China represents a unique evolutionary branch that has been isolated for more than twenty years from neighboring populations in Myanmar. The scarcity of information on population structure, sex ratio, and body condition makes it difficult to develop effective conservation measures for this elephant population. Twelve individuals were identified from 3,860 valid elephant images obtained from February to June 2018 (5,942 sampling effort nights) at 52 camera sites. Three adult females, three adult males, one subadult male, two juvenile females, two juvenile males and one male calf were identified. The ratio of adult females to adult males was 1:1, and the ratio of reproductive ability was 1:0.67, indicating the scarcity of reproductive females as an important limiting factor to population growth. A population density of 5.32 ± 1.56 elephants/100 km2 was estimated using Spatially Explicit Capture Recapture (SECR) models. The health condition of this elephant population was assessed using an 11-point scale of Body Condition Scoring (BCS). The average BCS was 5.75 (n = 12, range 2–9), with adult females scoring lower than adult males. This isolated population is extremely small and has an inverted pyramid age structure and therefore is at a high risk of extinction. We propose three plans to improve the survival of this population: improving the quality and quantity of food resources, removing fencing and establishing corridors between the east and wet parts of Nangunhe reserve.