Many European farmland bird populations are rapidly declining because of agricultural intensification and land-use changes. Robust estimates of population sizes and trends, habitat use, and protected area coverage within the distribution range are crucial to inform the conservation and management of threatened species. Here we report on the results of the 2019 Black-bellied Sandgrouse Pterocles orientalis (BBS) survey promoted and coordinated by SEO/BirdLife to update its breeding distribution, population size, and trends in continental Spain. A total of 660 grid cells, 10 × 10 km, Universal Transverse Mercator (UTM), were surveyed (81% of the distribution area), with 2,257 visits to 1,750 walked transects (7,001 km in total; 10.6 km per UTM). BBS was detected in 43% of sampled UTMs. At transect level, occupancy was 11% higher inside protected areas. At UTM level, occupancy was estimated at 0.58 (Bayesian credible interval [BCI] 95%: 0.55–0.61), revealing that BBS occupied about half of its previous breeding range (2003–2005). Using hierarchical distance sampling modelling, we estimated an average density of 1.33 individuals/km2 in occupied areas, and a population of 4,025 individuals (confidence interval: 1,840–7,609) within sampled areas, with an additional 697 individuals (confidence interval 461–1,075) in areas that were not surveyed. Further, the relative abundance of BBS (Kilometric Abundance Index) declined by 63% between 2005 and 2019 (annual decline rate of 4.5%). BBS used agricultural habitats (73%) and unprotected areas (54%) despite a higher occupancy within protected areas. Given the recent decline rate and persistent threats, the BBS conservation status should be upgraded to “Endangered” in peninsular Spain. Its future depends on land-use changes and agricultural practices, in particular the maintenance of fallows, semi-natural habitats, and pastures for extensive grazing. Better protection of important areas and targeted conservation initiatives should be promoted to halt and reverse the population decline in this key western Palearctic stronghold.