Given the global intensification of forest management and climate change, protecting and studying forests that develop free of direct human intervention-also known as primary forests-are becoming increasingly important. Yet, most countries still lack data regarding primary forest distribution. Previous studies have tested remote sensing approaches as a promising tool for identifying primary forests. However, their precision is highly dependent on data quality and resolution, which vary considerably. This has led to underestimation of primary forest abundance and distribution in some regions, such as the temperate zone of Europe. Field-based inventories of primary forests and methodologies to conduct these assessments are inconsistent; incomplete or inaccurate mapping increases the vulnerability of primary forest systems to continued loss from clearing and land-use change. We developed a comprehensive methodological approach for identifying primary forests, and tested it within one of Europe's hotspots of primary forest abundance: the Carpathian Mountains. From 2009 to 2015, we conducted the first national-scale primary forest census covering the entire 49,036 km 2 area of the Slovak Republic. We analyzed primary forest distribution patterns and the representativeness of potential vegetation types within primary forest remnants. We further evaluated the conservation status and extent of primary forest loss. Remaining primary forests are small, fragmented, and often do not represent the potential natural vegetation. We identified 261 primary forest localities. However, they represent only 0.47% of the total forested area, which is 0.21% of the country's land area. The spatial pattern of primary forests was clustered. Primary forests have tended to escape anthropogenic disturbance on sites with higher elevations, steeper slopes, rugged terrain, and greater distances from roads and settlements. Primary forest stands of montane mixed and subalpine spruce forests are more abundant compared to broadleaved forests. Notably, several habitat types are completely missing within primary forests (e.g., floodplain forests). More than 30% of the remaining primary forests are not strictly protected, and harvesting occurred at 32 primary forest localities within the study period. Almost all logging of primary forests was conducted inside of protected areas, underscoring the critical status of primary forest distribution in this part of Europe. Effective conservation strategies are urgently needed to stop the rapid loss and fragmentation of the remaining primary forests. Our approach based on precise, field-based surveys is widely applicable and transferrable to other fragmented forest landscapes.