This species is associated with gently flowing streams and riparian zones in dense lowland forest with a bushy understory (Sparreboom 2014). Predominantly nocturnal, adults hide under rocks in the water or in vegetation on the banks during the day, occasionally being found active after heavy rain (Sparreboom 2014). The species breeds in streams by larval development (Sparreboom 2014). Larvae and juveniles have not been observed to date in the wild (M. Bernardes pers. comm. August 2020). Habitat throughout much of this species' predicted range is undergoing a continuing decline in quality and extent due to agriculture (Sodhi et al. 2009).

This species is currently known only from approximately 400–800 m asl (Z.Yuan pers. comm. June 2019) in southern Guangxi Province, China (Huang et al. 1983, Fei et al. 2012) and Cao Bang Province, northern Viet Nam (Orlov et al. 2002, Nguyen et al. 2009), between 567–998 m asl (M. Bernardes pers. comm. August 2020). It is not expected to occur more widely in China (Z. Yuan pers. comm. June 2019). These may not represent the actual limits of the species' range as similar habitat and elevations to those in the species' known localities extend into adjacent parts of Bac Can and Lang Son Provinces, Viet Nam. Further surveys in these areas may uncover its presence, and its range has been projected beyond known sites to include these areas of suitable habitat. It occurs in 10 or fewer threat-defined locations, and its extent of occurrence (EOO) is 12,329 km².

Conservation Actions
A number of protected areas are included in parts of this species' range and it may occur in some of these, but none are confirmed at present (M. Bernardes pers. comm. August 2020). Paramesotriton sp. is listed in CITES Appendix II (M. Bernardes pers. comm. August 2020). Conservation related programmes have been carried out by the Institute of Ecology and Biological Resources (IEBR), through the Me Linh station for Biodiodiversity, Viet Nam and the Cologne Zoo, Germany, which have included attempts at captive breeding, capacity building, and raising public awareness (M. Bernardes pers. comm. August 2020).

Conservation Needed
It may be necessary to explore options for the increased protection of this species' habitat, and mechanisms to prevent the species being harvested from the wild. Ex-situ breeding is also recommended (M. Bernardes pers. comm. August 2020).

Research Needed
In order to ensure the species' long-term survival, the lack of data must be addressed; research should be carried out to determine its true distribution, relative abundance, population trends, and the effects of its harvest. An assessment of its habitat should also be carried out (M. Bernardes pers. comm. August 2020).