This paper reviews the experience and status of coastal aquaculture of seaweeds, mollusks, fish and crustaceans in eastern Africa and the islands of the western Indian Ocean. In many respects, coastal aquaculture is still in its infancy in the region, and there is a pressing need to formulate development strategies aimed at improving the income and assuring the availability of affordable protein to coastal communities. This paper also draws from positive and negative experiences in other parts of the world. The requirements of feed and fry, and the conversion of mangroves are used to illustrate how some aquaculture activities constitute a net loss to global seafood production. The paper presents both general and specific sustainability guidelines based on the acknowledgement of aquaculture as an ecological process. It is concluded that without clear recognition of its dependence on natural ecosystems, the aquaculture industry is unlikely to develop to its full potential in the region.