Traditional Hawaiian religious and healing practice, lomilomi included, came under sustained pressure following the overthrow of the Hawaiian kingdom and the islands' annexation by the United States, as missionary influence and, later, American territorial governance discouraged and in various periods actively restricted traditional Hawaiian religious and healing practice, a documented history of cultural disruption that closely affected how openly and how completely lomilomi could be transmitted across the affected generations.
The practice survived nonetheless within Hawaiian families and communities, sometimes practised quietly, and it has seen a marked and deliberate revival since the Hawaiian Renaissance of the 1970s onward, a broader movement of cultural, linguistic and religious reclamation among Native Hawaiians that placed lomilomi, alongside hula, the Hawaiian language and traditional wayfinding, among the practices actively recovered, taught and publicly reasserted as living Hawaiian heritage rather than left to fade. Contemporary lomilomi exists across a spectrum similar to several other indigenous bodywork traditions internationally, from practice maintained within specific Hawaiian family lineages with its full prayer and mana centred framing intact, to versions taught in wellness and spa training programmes, including outside Hawaii entirely, that retain the name and the basic long stroke technique while varying considerably in how much of the underlying spiritual practice they preserve.