Protein from wildlife (including fish) is crucial to food security, nutrition and health across the tropics. The harvest of duikers, antelopes, pigs, primates, rodents, birds, reptiles and fish provides invaluable benefits to local people both in terms of income and of improved nutritious diets. It also creates, often linked with commercialization, some very important health issues with the spread of several life-threatening diseases (Ebola, SARS). Vulnerability of the resource to harvest varies, with some species sustaining populations in heavily hunted secondary habitats, while others require intact forests with minimal harvesting to maintain healthy populations. Global attention has been drawn to biodiversity loss through debates regarding bushmeat, the “empty forest†syndrome and their ecological importance. However, information on the harvest and the trade remains fragmentary, along with understanding of their ecological, socioeconomic and cultural dimensions. Here we assess the consequences, both for ecosystems and local livelihoods, of the loss of these important resources and propose alternative management options.