The polyphagous shot hole borer (Euwallacea nr. fornicatus, Coleoptera: Curculionidae: Scolytinae), an exotic and invasive ambrosia beetle, was recently found attacking a number of tree species in Los Angeles, Orange, Riverside, and San Diego Counties in southern California. Their colonization and subsequent inoculation of a suite of symbiotic fungi that cause Fusarium Dieback, has resulted in extensive mortality of some tree species, including, California sycamore (Platanus racemose Nutt.). There are no sustainable control options for polyphagous shot hole borer other than maintaining tree vigor and removal of severely infested host material. The effectiveness of therapeutic treatments of an injected systemic insecticide containing emamectin benzoate (EB) alone and in combination with a systemic fungicide, propiconazole (P), was evaluated over a 4-yr period for maintaining the health of individual sycamore trees infested by polyphagous shot hole borer. All treatments containing EB reduced levels of polyphagous shot hole borer colonization and associated sap flow at attack sites compared to untreated controls. A second trial evaluated preventative treatments of EB and P alone or combined to protect individual sycamore from colonization by polyphagous shot hole borer. After 45 mo posttreatment, all treatments significantly reduced polyphagous shot hole borer attack levels and successful attacks compared to untreated controls (EB + P > EB alone > P alone). We concluded that EB alone or combined with P are acceptable therapeutic and preventative treatments for management of polyphagous shot hole borer in California sycamore in southern California.