In the Flora of China 4: 87 (1999), this species is treated as a synonym of Cephalotaxus mannii. However, in a note the co-author Robert Mill considered the plants from Hainan to be separable as the species named and described by H.L. Li, i.e. C. hainanensis. Mill gives a statement on morphological differences between the two species. Under this narrower species circumscription it is possible that other specimens from southern China and northern Viet Nam would have to be included under C. hainanensis, with consequences for its distribution and hence conservation status. Ying et al. (2004) map this species as occurring in western Guangdong, Hainan, southeastern and western Guanxi, western Yunnan, and even southeastern Xizang [Tibet]. The populations of Yunnan and Tibet are here treated as belonging to C. mannii. A critical modern revision of the genus to resolve these issues is lacking at present. This assessment treats this taxon as being endemic to Hainan
The bark and leaves contain valuable medicinal compounds such as cephalotaxine and harringtonine. Trees would also have been logged in the past for their timber.