Commercial harvests can threaten tree species harvested for their bark. Amphipterygium adstringens is a dioecious tree, endemic to the tropical dry forests of Mexico, where it is intensively harvested for its medicinal bark. Limited information hinders developing sustainable management strategies for A. adstringens. We assessed bark regeneration for male and female trees, and evaluated the effect of tree sex and diameter, debarking treatments and cutting seasons on bark regeneration and tree survival rates. Bark regeneration was higher for wet season harvested trees (vs. dry), regardless of their sex. Bark regeneration was higher on female than on male trees. There were significant interactions of harvest season, harvest treatment and tree sex diameter on bark regeneration and survival. Overall, the highest bark regeneration rates occurred in female trees with ≥20.1 cm diameter that were wet season harvested with a 50% debarking intensity. Consequently, wet season and intermediate intensity harvests appear to foster sound management, but we recommend against targeting exclusively a single demographic group (i.e., large female trees) due to potential negative impacts on species demography and bark supply. A grounded strategy for sustaining bark harvest would also need to take into account relevant aspects of local socio-ecological context, including harvest interactions with other land uses.