Marine and land ecosystems provide many benefits to society. Marine ecosystems are under increased pressure because of climate change, expanding human populations and needs. Increased pressures and associated impacts on ecosystems often render current management and conservation policies inappropriate to mitigate or regulate such pressures and maintain the level of ecosystem benefits provided. Integrated approaches centred on ecosystems can help assess synergies and trade offs for delivery of benefits provided by ecosystems for management options with different levels of usage and conservation. The ecosystem service framework can help structure the production of comprehensive assessments drawing from multi-disciplinary academic knowledge and management experience. Interaction and dialogue with stakeholders structured by a step-wise iterative ‘triage’ process can help ensure ecosystem assessment outputs are meaningful, salient (reflecting the interests of those involved), useful to management and policy concerns, needs and projects, and feasible under available knowledge and resources. The ecosystem service framework needs to be applied at regular intervals to gain an idea of how the benefits derived from ecosystems evolve in time. Using the ecosystem service framework in combination with the DPSIR framework to identify Drivers, Pressures, States, Impact, Response can provide very rich insights to discussions for establishment of management plans and policies for marine conservation, especially those aiming to mitigate or adapt to climate change pressure, for delivery of healthy ecosystems and associated human well-being.