Fishing gear entanglements can compromise health and lower survival and reproductive output of wildlife, which can slow population growth or cause population declines. However, entanglements may go unobserved, making it difficult to quantify their effects on individuals' vital rates and a population's trajectory. Fishing gear entanglements are a leading cause of death for North Atlantic right whales, Eubalaena glacialis, an endangered species whose population has declined substantially over the last decade. Key sources of observation error have not been addressed when quantifying the effects of entanglement on this species. We formulated a hidden Markov model that integrated 28 years of photo identification records, visual health assessments, entanglement assessments, and hormone assays to estimate body condition dynamics, and entanglement, survival, and reproductive rates of female North Atlantic right whales. The model also accounted for observation errors, including entanglements and reproductive events that were unobserved. Whales entangled in fishing gear were drastically more likely to experience declines in body condition and had lower survival rates than whales that were not entangled. Additionally, only whales in good body condition became pregnant. Between 1994 and 2021 entanglements reduced the expected number of calves born by 12.9% (95% credible interval: 8.2%–19.6%) and the expected number of females alive at the end of 2021 by 18.5% (95% credible interval: 8.6%–29.4%). Fishing gear entanglements have reduced the North Atlantic right whale population's capacity to recover and have increased the importance of the health and survival of the remaining living whales. Therefore, reducing the risk of fishing gear entanglements is likely necessary for the population to recover.