The emergence of an ecosystem approach to fisheries (EAF) was characterized by the adoption of objectives for maintaining ecosystem health alongside those for fisheries. The EAF was expected to meet some aspirations for biodiversity conservation, but health was principally linked to sustainable use rather than lower levels of human impact. Consequently, while policies including EAF concepts identified objectives for fisheries management and biodiversity conservation, the wording often reflected unresolved societal and political debates about objectives and gave imprecise guidance on addressing inevitable trade-offs. Despite scientific progress in making trade-offs and consequences explicit, there remain substantial differences in interpretations of acceptable impact, responses to uncertainty and risk, and the use of management measures by groups accountable for fisheries management and biodiversity conservation. Within and among nations and regions, these differences are influenced by the contribution of fisheries, aquaculture, farming, and trade to food security, consumers’ options, and other social, economic, and environmental factors. Notwithstanding, mutual understanding of the motivations and norms of fisheries management and biodiversity conservation groups is increasing, and interactions between these groups have likely supported more progress toward meeting their stated objectives than would have otherwise been achievable.