Small-scale coastal capture fisheries produce almost half the fish consumed in low- and middle- income countries and employ more people than all other ocean economic sectors combined, but their resilience is undermined by distal and proximate drivers. Comanagement of small-scale coastal and inland fisheries contributes to social, economic and environmental objectives, but evidence and outcomes for gender equity, nutrition, and social-ecological gains are lacking. Methodological, technical and governance innovations (e.g. handbooks for gender equity and social inclusion, fish aggregating devices, compensation schemes for fishery closures) can help progress these outcomes. Participatory diagnostic tools that harness voices from local organizations, coastal communities and women’s groups can guide sustainable and appropriate improvements to fish-based livelihoods. Increasingly on coasts, the scale of changes or shocks exceed the reach or impact of comanagement or local livelihood interventions. Structural adjustments or responses must be well informed to navigate trade-offs in response.