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Tetradactylus fitzsimonsi has an extent of occurrence (EOO) of ca 10,955 km², the population is severely fragmented, with a continuing decline in EOO for the area, extent and quality of habitat due to a variety of threats including crop farming and wood plantations, and infrastructure development. The species is therefore considered Vulnerable.
Endemic to the Eastern and Western Cape provinces, South Africa. Recorded from only four areas, i.e. Port Elizabeth, near Humansdorp in the Eastern Cape, George and Knysna (a recent record) in the Western Cape. The distribution of these records suggest there are four disjunct subpopulations, the largest around Port Elizabeth (>50% of known records). Very few specimens are known: the most recent specimen from the Port Elizabeth area was collected in 1991, the two Humansdorp specimens were collected in 1999, the three George specimens were found in 1931, and a specimen was recently recorded from Knysna (iSpot number: 592219).
There is no information currently available on population size or trends, but the species is known from only about 15 museum specimens, suggesting it is rare, or perhaps difficult to find. It is likely that more than half the individuals occur in subpopulation with little connectivity, so the species is considered severely fragmented.
Threats include use of land for crop farming and wood plantations, infrastructure development (industry, urbanization, tourism, roads), invasive alien plants, fires and agricultural pollution. These threats are particularly severe in and around Port Elizabeth, a highly developed area. Interrogation of the National Landcover data suggests that the majority of the habitat is transformed (Geo Terra Image, 2015, 2016).
There are very few records of this species, so more comprehensive survey data would improve our understanding of its distribution and habitats. The species may occur in one protected area.