Abstract The ecosystem approach to fisheries (EAF) is a holistic paradigm that considers stocks of exploitable species, marine ecosystems, and stakeholders. Management agencies must strike a balance between their capacity constraints and the requisites of management measures. Most small-scale sea cucumber fisheries of the Pacific Islands have been plundered while others are being opened to commercial exploitation. Data from fishery managers and a regional workshop were used to assess the current problems, institutional constraints, and solutions to the management of sea cucumber fisheries in 13 Pacific Island countries (PICs). Technical capacity was often strong for some management actions such as developing marine reserves but weak for others, such as enforcement. Using multi-disciplinary indicators, half of the fisheries were diagnosed by their managers as being overfished or depleted, despite evidence of optimistic bias. Fishery governance varied greatly among the PICs, and co-management frameworks were not typical of any cultural region. Management objectives were prioritized differently among managers but the most highly ranked was to protect ecological resilience. The fishery managers proposed different sets of regulatory measures and various management actions, such as surveys to collect socio-economic and fishery-dependent data, support for local governance, and strong enforcement – all widely under-practiced. Pacific sea cucumber fisheries exemplify how the transition to an EAF by management institutions must involve reorganization of their technical and human-resource capacities among management tasks. Levies on exports need to be internalized to fund improved management. Management agencies should consider a shift in resources from developing marine reserves, conducting underwater surveys, and aquaculture-based restocking to strengthening enforcement capacity, stakeholder involvement, and communication with fishers. In concert with these actions, short fishing seasons, shortlists of allowable species and tighter enforcement at export points may serve to turn the tide on boom-and-bust exploitation and safeguard biodiversity.