Abstract We compared tree growth and crown condition with soil and foliar elemental composition in 14 sugar maple ( Acer saccharum Marsh.) stands in VT, USA, to evaluate if deficiencies or imbalances in cation nutrition were associated with growth and health reductions in native stands. The Till Source Model (TSM) was used to select study sites potentially high or low in calcium (Ca) by predicting the relative Ca concentration of soil parent material derived from glacial till. The TSM successfully identified high or low levels of soil Ca ( P = 0.031) and foliar Ca ( P = 0.011) among stands. Although soil Ca, potassium (K), phosphorus (P), and iron (Fe) concentrations were all associated with stand growth and health, the influence of K, P, and Fe on health appeared indirect and potentially a result of autocorrelations between Ca and these nutrients. The only cases where improved health coincided with increased soil element content involved Ca and molar ratios of Ca and aluminum (Al). Among foliar nutrients, significant relationships with elevated branch dieback were only found for low foliar Ca ( P = 0.021) and high foliar Al ( P = 0.035). Average annual basal area growth during the decade prior to sampling was lower for trees in stands with low foliar Ca ( P = 0.050) and high foliar Al ( P = 0.017). These data emphasize the importance of Ca and Al to sugar maple health and highlight the vulnerability of sugar maple stands to declines in growth and vigor following continued anthropogenic Ca depletion.