Coral reef fisheries are increasingly commercialized, and demand for reef fishes is growing globally. Pressures come from domestic markets for food, tourism, livelihoods and other community needs, and internationally for food, and for non-food uses such as the aquarium trade. Export trade represents a particular set of challenges and opportunities for developing countries because many of their fisheries are already overexploited and unlikely to meet projected domestic needs without management for sustainability. Although international trade data only allow for a preliminary analysis, it is clear that export volumes, at least for some food fish, can be significant in scale relative to source fish populations. While they provide income, job opportunities, and foreign exchange, export fisheries may not always benefit source communities in developing countries, may exacerbate overfishing, can threaten biodiversity, involve human and fish welfare problems, and may leave socially and biologically damaging legacies. To improve benefits from international trade and address these problems, action is needed by importing and exporting countries, from greater emphasis on domestic food security, assessment of biological, economic, and social implications of international trade, monitoring, and involvement by fishers in decision-making, as well as adoption of better fishing and trade practices. Importing countries can improve trade monitoring and promote trade and consumption practices that complement the actions of source countries. Greater biological and socioeconomic benefits gained from exports should foster better stewardship and help safeguard biodiversity in reef ecosystems in general.