High elevation five-needle pines are rapidly declining throughout North America. The six species, whitebark (Pinus albicaulis Engelm.), limber (P. flexilis James), southwestern white (P. strobiformis Engelm.), foxtail (P. balfouriana Grev. & Balf.), Great Basin bristlecone (P. longaeva D.K. Bailey), and Rocky Mountain bristlecone pine (P. aristata Engelm.), have limited timber value but are of great ecological and symbolic importance to both the U.S. and Canadian West. A comprehensive International symposium, called the High Five symposium, was held June 28-30, 2010, in Missoula, Montana to: (1) bring together scientists, managers, and concerned citizens to exchange information on the ecology, threats, and management of these pines; (2) learn about the threats and current status of pine populations; (3) describe efforts to mitigate threats through restoration techniques and action plans; and, (4) build a foundation for the synthesis of research efforts and management approaches. These proceedings present reports of some of the presentations given at the conference in the form of abstracts, extended abstracts, papers, and plenary papers in the areas of ecology, disturbance dynamics, genetics, climate change, and restoration techniques.