The rapidly evolving ocean economy, driven by human needs for food, energy, transportation and recreation, has led to unprecedented pressures on the ocean that are further amplified by climate change, loss of biodiversity and pollution. The need for better governance of human activities in the ocean space has been widely recognized for years, and is now also incorporated in the United Nations Sustainable Development Goals. Even so, many challenges relating to the implementation of existing governance frameworks exist. Here, we argue that integrated ocean management (IOM) should be the key overarching approach-building upon and connecting existing sectoral governance efforts-for achieving a sustainable ocean economy. IOM is a holistic, ecosystem-based and knowledge-based approach that aims to ensure the sustainability and resilience of marine ecosystems while integrating and balancing different ocean uses to optimize the overall ocean economy. We discuss examples of IOM in practice from areas where preconditions differ substantially, and identify six universal opportunities for action that can help achieve a sustainable ocean economy.