We reviewed forest management in the mountainous regions of several northwestern states and California in the United States and how it has impacted current issues facing these forests. We focused on the large-scale activities like fire suppression and logging which resulted in landscape level changes. We divided the region into two main forests types; wet, like the forests in the Pacific Northwest, and dry, like the forests in the Sierra Nevada and Cascade ranges. In the wet forests, the history of intensive logging shaped the current forest structure, while fire suppression played a more major role in the dry forests. Next, we looked at how historical management has influenced new forest management challenges, like catastrophic fires, decreased heterogeneity, and climate change. We then synthesized what current management actions are performed to address these issues, like thinning to reduce fuels or improve structural heterogeneity, and restoration after large-scale disturbances. Lastly, we touch on some major policies that have influenced changes in management. We note a trend towards ecosystem management that considers a forest’s historical disturbance regime. With expected climate induced changes in fire frequency, it is suggested that fuel treatments be implemented in dry forests to ensure an understory fire regime is restored in these forest systems. With respect to wet forests in this region, it is suggested that there is still a place for stand-replacing fire regimes. However, these forests will require structural changes incorporating heterogeneity to improve their resiliency and health.