Land rehabilitation is proposed as a management strategy to reverse the negative consequences of tropical deforestation and land degradation. We first define the concepts associated with ecosystem modification—conversion, damage, and degradation—and those associated with ecosystem repair—restoration, rehabilitation, and reclamation. We then present a scheme of sustainable land use in the tropics, with illustrations of how rehabilitation and restoration activities fit into the overall scheme of the use of land. Because damaged lands cannot contribute effectively to sustained economic development, land rehabilitation is a necessary step for increasing the chances of attaining sustainability. Approaches for rehabilitating ecosystems are discussed, including the management of stressors and subsidies in relation to their point of interaction in the ecosystem. Finally, we illustrate the concepts of ecosystem rehabilitation of damaged, degraded, and derelict lands with examples of case studies from dry to humid life zones in island and continental situations throughout the tropics. The case studies demonstrate that opportunities for success exist, even with severely degraded lands, but a considerable amount of research remains to be done before we have a full understanding of the complexity of the task facing us.