<p>Shallow-water tropical coral reef ecosystems face an escalating crisis driven by cumulative local pressures and global stressors resulting from climate change. In this Review, we assess the status and trends of coral reefs and their future trajectories under local and global stressors, and focus on identifying and assembling the solutions required to avoid collapse of coral reef ecosystems. A large fraction of coral reefs has been degraded, and a disproportionate share of these losses has occurred in the past decade. Conservation efforts must urgently focus on layering a suite of coordinated, innovative interventions to mitigate local and global stressors; increase the resistance of coral colonies, both wild and outplanted, to thermal stress; repair ecosystem functions, such as grazing, that support resilient reef ecosystems; expand area-based protection; and cost-effectively restore coral reef ecosystems and their services at the scale required to meet global biodiversity goals. We call for a major, collaborative effort around a global emergency action plan that catalyses the governance, financial, management and scientific actions required to address the coral reef crisis and mobilizes society to promote global action while empowering Indigenous and local communities’ agency and leadership in driving local action to conserve and restore coral reefs.</p>