Increasing wildfire risk in Alaska has prompted the adoption of fuel reduction treatments, including hand-thinning and mechanical mastication, to mitigate fire behavior and improve firefighter safety. This intensification of forest management creates disturbances that may negatively, neutrally, or positively influence tree health conditions, including tree mortality, wind damage, disease, and one of the most wide-spread health threats to these forests, bark beetle infestations. This study evaluated the effects of fuel reduction treatments on adverse tree health conditions by surveying 33 sites across two regions experiencing endemic and outbreak levels of spruce beetle infestation in Alaska. We assessed tree mortality, wind damage, disease occurrence, and bark beetle infestation across control, edge, and treatment transects within both hand-thinned and masticated sites. Our results show that in the region with endemic levels of spruce beetle (endemic region), the probability of occurrence of adverse tree health conditions did not differ between trees in control, edge, and treatment transects at hand-thinned sites, or between control and edge transects at masticated sites. This suggests that fuel reduction treatments have no significant impact on forest health in the continental boreal forest of the endemic region. In the more maritime outbreak region, which has recently experienced significant spruce mortality due to the spruce beetle, we found that leave trees in hand-thinned treatments were more likely to be healthy. At hand-thinned sites, trees in treatment transects had 4.1 (95% CI = [1.2, 14.0]) times greater odds of being alive than edge trees, which had 2.1 (CI = [1.2, 3.6]) times greater odds of being alive than control trees, while at masticated sites, control trees had 1.5 (CI = [1.2, 2.1]) times the odds of being alive than edge trees. In the outbreak region, at hand-thinned sites, white spruce in the control had 11.4 (CI = [2.9, 45.41]) times greater odds of past or current spruce beetle presence than in the edge, and 27.8 (CI = [3.3, 237.0]) times greater odds than in the treatment, but there was no effect of transect on spruce beetle presence in black spruce, or in either white spruce or black spruce at masticated sites. In the outbreak region, the probability of occurrence of wind damage and diseases did not differ between trees in control, edge, and treatment transects at hand-thinned sites, or between control and edge transects at masticated sites. Our results show that fuel reduction treatments, particularly hand-thinning, effectively reduced the density of dead trees and did not significantly increase tree mortality, wind damage, disease, or bark beetle infestation, with the exception of an increase in northern spruce engraver and disease presence along the edges of masticated sites in the outbreak region. Overall, our findings suggest that fuel treatments reduce hazardous dead trees without sacrificing the health of the remaining trees, providing support for fuel treatments as a low-risk strategy for forest management.