Environmental impact assessment (EIA) is an important environmental policy instrument to proactively inform development decisions that might impact biodiversity, especially in internationally recognised biodiversity hotspots. One such hotspot region is the Succulent Karoo Biodiversity Hotspot (SKBH), known for its rich endemism of flora and fauna. The aim of this research is to determine the quality of biodiversity inputs to EIA in areas with high biodiversity value, such as the SKBH. This was achieved by reviewing the quality of biodiversity inputs to 16 EIAs against a tailor-made review package. The review produced ‘unsatisfactory’ results related to the integration of biodiversity impacts, public participation, and continual monitoring. ‘Satisfactory’ results were achieved for the consideration of ecological approaches, description of the baseline environment, and the application of the precautionary principle. To address the unsatisfactory results, we recommend the development of context specific guidelines dealing with (i) significance thresholds, (ii) alternatives and mitigation, and (iii) monitoring plans. Standard approaches, guidelines, and general competencies do not suffice for EIA in biodiversity hotspots.