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1. Marine Protected Areas (MPAs) are a major tool to conserve marine ecosystems but are also strongly attractive to tourists, the increased numbers of which can cause environmental issues if not properly managed.2. Proposing an MPA and then failing to establish it risks advertising the beauty of a marine area without managing the unavoidable increase in tourism. This is what happened at Gallinara Island (Ligurian Sea, north-western Mediterranean), where an MPA was proposed in 1990 but has not yet been established. 3. Benthic data collected soon after the proposal (1990-92) have been compared with similar information obtained in subsequent periods (2009 and 2016): change has been assessed both visually and statistically, using multivariate and univariate techniques. 4. The Gallinara sea floor supported five epibenthic communities in 1991, four of which corresponded to European Nature Information System (EUNIS) habitats; the fifth epibenthic community, characterized by the erect sponge Axinella polypoides, should be included in the next revision of EUNIS. 5. In the 25 years since the original MPA proposal, all epibenthic communities have exhibited a reduction in their three-dimensional structure and biotic homogenization, and severe decreases in species diversity, and the sea floor has been littered with derelict fishing gear and other waste from boats. 6. In absence of the MPA, proposals to develop a management plan for a marine Site of Community Importance (SCI) have been provided, to reduce sea-based human pressures. The dramatic alteration of Gallinara sea floor after 25 years of negligence and inaction is a sad warning for other unmanaged yet beautiful natural areas within urbanized regions of the world.

Worldwide coral reef decline appears to be accompanied by an increase in the spread of hard coral diseases. However, whether this is the result of increased direct and indirect human disturbances and/or an increase in natural stresses remains poorly understood. The provision of baseline surveys for monitoring coral health status lays the foundations to assess the effects of any such anthropogenic and/or natural effects on reefs. Therefore, the objectives of this present study were to provide a coral health baseline in a poorly studied area, and to investigate possible correlations between coral health and the level of anthropogenic and natural disturbances. During the survey period, we recorded 20 different types of coral diseases and other compromised health statuses. The most abundant were cases of coral bleaching, followed by skeletal deformations caused by pyrgomatid barnacles, damage caused by fish bites, general pigmentation response and galls caused by cryptochirid crabs. Instances of colonies affected by skeletal eroding bands, and sedimentation damage increased in correlation to the level of bio-chemical disturbance and/or proximity to villages. Moreover, galls caused by cryptochirid crabs appeared more abundant at sites affected by blast fishing and close to a newly opened metal mine. Interestingly, in the investigated area the percentage of corals showing signs of ‘common’ diseases such as black band disease, brown band disease, white syndrome and skeletal eroding band disease were relatively low. Nevertheless, the relatively high occurrence of less common signs of compromised coral-related reef health, including the aggressive overgrowth by sponges, deserves further investigation. Although diseases appear relatively low at the current time, this area may be at the tipping point and an increase in activities such as mining may irredeemably compromise reef health.