The southern extent of the boreal forest in North America has experienced intensive human disturbance in the past decades. Among these, forest harvesting leads to the substantial loss of late-successional stands that include key habitat attributes for several avian species. The American Three-toed Woodpecker, Picoides dorsalis, is associated with continuous old spruce forests in the eastern part of its range. In this study, we assess the influence of habitat characteristics at different scales on the occupancy of American Three-toed Woodpecker in a heavily managed boreal landscape of northeastern Canada, and we inferred species occupancy at the regional scale. We conducted 185 playback stations over two breeding seasons and modelled the occupancy of the species while taking into account the probability of detection. American Three-toed Woodpecker occupancy was lower in stands with large areas recently clear-cut, and higher in landscapes with large extents of old-growth forest dominated by black spruce. At the regional scale, areas with high probability of occupancy were scarce and mostly within protected areas. Habitat requirements of the American Three-toed Woodpecker during the breeding season, coupled with over-all low occupancy rate in our study area, challenge its long-term sustainability in such heavily managed landscapes. Additionally, the scarcity of areas of high probability of occupancy in the region suggest that the ecological role of old forest outside protected areas could be compromised.