Population outbreaks of Crown-of-Thorns Starfish (COTS; Acanthaster spp.) are a major contributor to loss of hard coral throughout the Indo-Pacific. On Australia's Great Barrier Reef (GBR), management interventions have evolved over four COTS outbreaks to include: (1) manual COTS control, (2) Marine Protected Area (MPA) zoning, and, (3) water quality improvement. Here we evaluate the contribution of these three approaches to managing population outbreaks of COTS to minimize coral loss. Strategic manual control at sites reduced COTS numbers, including larger, more fecund and damaging individuals. Sustained reduction in COTS densities and improvements in hard coral cover at a site were achieved through repeated control visits. MPAs influenced initial COTS densities but only marginally influenced final hard coral cover following COTS control. Water quality improvement programs have achieved only marginal reductions in river nutrient loads delivered to the GBR and the study region. This, a subsequent COTS outbreak, and declining coral cover across the region suggest their contributions are negligible. These findings support manual control as the most direct, and only effective, means of reducing COTS densities and improving hard coral cover currently available at a site. We provide recommendations for improving control program effectiveness with application to supporting reef resilience across the Indo-Pacific.