As global energy demand increases, the rapid expansion of the unconventional fossil fuel sector has triggered an urgent need for social, economic and policy research to understand and predict how this sector affects host communities and how governance systems can respond to changes presented by this sector. In response to this need, this paper addresses three linked objectives. The first is to review the literature on regional impacts of energy extraction, presented in the form of a framework of hierarchical effects. The second is to consider how these are playing out differently in the context of conventional compared with unconventional fossil fuels. The third is to draw attention to the institutional avenues for addressing these impacts, including an overview of the lessons from existing research on the human and policy dimensions associated with conventional energy industries. In particular, we consider the importance of multistakeholder dialogue, which plays an important role in how regions respond to the challenges brought about through extractive industries. Overall, we demonstrate that experiences from conventional energy development provide a useful starting point for navigating the human and policy dimensions of unconventional energy for host communities and discuss how these experiences differ when unconventional energy seeks to co-exist with other land uses such as agriculture. The paper draws attention to the dispersed nature of impacts (positive and negative) and how this may shape winners and losers from unconventional energy development, particularly in regions with pre-existing land uses such as agriculture.