Gorgonian corals occurring in shallow waters are vulnerable to changing environmental conditions and human-related pressures such as pollution, overfishing, and diseases. However, anthropogenic effects on coral systems are difficult to quantify due to the lack of base-line data of unaffected populations. In order to assess the impact of global and ... local environmental parameters on gorgonian populations removed from direct anthropogenic impact, we evaluated demographic parameters and the health status of Pacifigorgia cairnsi (Gorgoniidae: Octocorallia) populations in Malpelo Island, a remote and pristine marine area in the Tropical Eastern Pacific of Colombia. Specifically, we studied P. cairnsi densities and population size structures under different habitat and local environmental conditions. We also studied whether ENSO events and local hydrodynamic features including locality, water depth, and upwelling conditions drive P. cairnsi growth rates. Finally, we evaluated the prevalence of the necrotic patch disease and rates of disease recovery. Major findings were that local hydrodynamic parameters shaped P. cairnsi size structures, that growth rates were affected by thermal anomalies associated to ENSO events and partly by water depth, that overall disease prevalence was low (6%) and that it did not correlate with the environmental parameters studied, and that most diseased colonies (57%) recovered via tissue breakage. The fact that P. cairnsi, a keystone species within the regional benthic food web, is affected by thermal anomalies remains of concern because these global events are predicted to increase in frequencies and severity in the future. Nonetheless, the low level of disease prevalence found indicates that the island’s pristine conditions might facilitate disease resistance. Moreover, the findings suggest an interesting trade-off between growth rates and colony recovery in shallow waters related to tissue breakage. This study provides crucial base-line data for future investigations aiming at understanding coral responses to anthropogenic pressures and the impact of global climate change on coral communities.