The 27 extant species of sturgeons and paddlefishes (Order Acipenseriformes) represent a unique and relict lineage of fishes. Producers of coveted black caviar, sturgeons are one of the most valuable wildlife commodities on earth. The group is among the most endangered fishes with all species listed under Convention on International Trade in Endangered Species (CITES) Appendix I (two species) or II (25 species), only two species considered Lower Risk by IUCN, four of the nine US taxa and one Caspian species protected under the Endangered Species Act, and local extinctions recorded for 19 of 27 species. Despite their well-publicized imperilled status, commercial pressure on 15 species persists. Here, after reviewing the biological characteristics of sturgeons and paddlefishes and their commercial use, an overview of global fisheries is presented. The synopsis demonstrates that, with few exceptions, sturgeon and paddlefish are imperilled across the globe and long-term survival in the wild is in jeopardy. All major sturgeon fisheries have surpassed peak productivity levels, with 70% of major fisheries posting recent harvests <15% of historic peak catches and 35% of the fisheries examined crashing within 7–20 years of inception. Even in Caspian Sea fisheries, the most important globally, present catches are below 10% of historic peak landings. Improved domestic and international fisheries management and attention to habitat and species restoration is now needed. Although captive rearing offers promise for caviar alternatives and endangered species restoration, it must advance cautiously to avoid environmental harm. To ensure a continued supply of caviar and the survival of these unique fishes we offer recommendations for priority conservation action for the future.