Throughout the Caribbean, coral reefs are transitioning from rugose, coral-dominated communities to flat, soft coral-dominated habitats, triggering declines in biodiversity. To help mitigate these losses, artificial structures have been used to re-create substrate complexity and support reef inhabitants. This study used natural and artificial structures to investigate the factors influencing the use of habitat by reef fish. During 2018 and 2019, divers added artificial structures and monitored the fish assemblages associating with both the artificial structures and naturally occurring corals. Overall, there were more fish on natural structures than on artificial structures. While structure shape did not influence fish use, there was a non-significant trend for increased use of larger structures. Fish observations did not differ across a gradient of shallow, complex reefs to deeper, flatter reefs; however, analyses of feeding guilds revealed clearer patterns: herbivores and omnivores were positively associated with low rugosity reefs where macroalgal abundance was higher, whereas invertivores preferred more rugose reefs. These results suggest that as reefs lose structural complexity, fish communities may become dominated by herbivores and omnivores. It also appears that the addition of artificial structures of the type used here may not mitigate the effects of structure loss on reef fish assemblages.