Tropical coral reefs are charismatic ecosystems that house a significant proportion of the world's marine biodiversity. Their valuable goods and services are fundamental to the livelihood of large coastal populations in the tropics. The health of many of the world's coral reefs, and the goods and services they provide, have already been severely compromised, largely due to over-exploitation by a range of human activities. These local-scale impacts, with the appropriate government instruments, support and management actions, can potentially be controlled and even ameliorated. Unfortunately, other human actions (largely in countries outside of the tropics), by changing global climate, have added additional global-scale threats to the continued survival of present-day coral reefs. Moderate warming of the tropical oceans has already resulted in an increase in mass coral bleaching events, affecting nearly all of the world's coral reef regions. The frequency of these events will only increase as global temperatures continue to rise. Weakening of coral reef structures will be a more insidious effect of changing ocean chemistry, as the oceans absorb part of the excess atmospheric carbon dioxide. More intense tropical cyclones, changed atmospheric and ocean circulation patterns will all affect coral reef ecosystems and the many associated plants and animals. Coral reefs will not disappear but their appearance, structure and community make-up will radically change. Drastic greenhouse gas mitigation strategies are necessary to prevent the full consequences of human activities causing such alterations to coral reef ecosystems.