European beech (Fagus sylvatica) grows at the southern limit of its range in the mountain-Mediterranean vegetation belt up to the timberline. The southernmost beech forests of Sicily (southern Italy) show peculiar ecological, structural and silvicultural characteristics, growing in fragmented and isolated stands near the timberline and in topographically marginal unfavorable habitats. Past silvicultural practices increased the heterogeneity of stand structure at these sites. We compared stand structural characteristics and tree health in coppice-cut and control beech stands with respect to the local topographic gradient (bottom, slope and ridge) and canopy cover (clearing/border vs. interior trees). Our results clearly showed a correlation between declining tree health (crown and bark damage, higher percentage of dead trees and lower seedling density) and recent coppice-cuts, poor (marginal) site quality (on ridges and slopes) and reduced canopy cover (in clearing/border trees). The decrease of tree health indicate an increasing threat to the long-term viability of beech stands facing multiple environmental stress factors (such as those related to southern latitude and topographic position). Declining tree health in the control plots also supports this hypothesis. We concluded that traditional forest management practices, such as coppice-cuts applied regardless to the specific microenvironmental conditions, may pose a risk to beech forest health at the southernmost edge of the species' range.