Major threats for Trapa natans population in North Macedonia are changes of water levels in lakes, lot of mud (Prespa Lake, Dojran Lake) and melioration of wetlands. This leads to continuing declines in the area of occupancy, extent of occurrence and quality of habitat. The population is not connected with the populations in the neighboring countries.

According to the global assessment on the IUCN Red list, the species is Least Concern (LC), while in Balkan, Mediterranean and Europe it is classified as Data Deficient (DD).

Trapa natans has long been consumed by humans across the world especially its nut-like fruit. The nuts have a high moisture content and are valued for quenching thirst as well as being used as a source of flour that forms the base for many different food products. The nuts’ composition consists of 15% protein, 7.5% fat, 52% starch, 3% sugar and 22.5% water (Hummel and Kiviat, 2004).

The status of species Trapa natans in the Balkans needs to be clarified and more information is needed to make an assessment.

The species is included under Appendix I of the Convention on the Conservation of European Wildlife and Natural Habitats (Bern Convention).

The shoreline of the Ohrid Lake, where this species occurs, is declared as World Heritage Site by UNESCO. Areas of Prespa Lake (Ezerani) and Dojran Lake, where this species is presents, are Ramsar Sites. One of the species locality is Monospitovo – the largest wetland in North Macedonia which protection is priority.