The stream orchid or false helleborine orchid (Epipactis gigantea) is a critically imperiled plant that occurs at Filoha Meadows Nature Preserve. This report documents the third year of a long-term monitoring study tracking annual populations trends of this orchid and investigating the effect of noxious weed control actions on the persistence of this rare plant species. In 2020, the density of the orchid population at Filoha was slightly less than in 2019, but still higher than 2018. Orchid density appears to be highly correlated with precipitation patterns the preceding winter and spring, with lower densities observed in hot dry years. We observed no adverse effects to the stream orchids from Canada thistle (Cirsium arvense) control efforts which included both herbicide and mechanical (hand-pulling) treatments. To date, the Canada thistle rust fungus, a biological control agent, has yet to become established despite three years of releases and hence its efficacy is unknown.