Valuing Caribbean biodiversity for health and wealth requires knowledge of the bioresource so as to better appreciate the myriad of uses and services it provides. Increasing the knowledge base provides increasingly accurate valuation, which hopefully will lead to better management and sustainable use of this biodiversity. The Caribbean region comprises 229,540 km 2 of land (only 10% of which is still in original forest cover) and 2,754,000 km 2 of ocean. In the region there are about 13,000 identified plant species of which 205 genera and 6500 species are endemic. The marine area, with a maximum depth of 7686 m, includes the world's second largest barrier reef. It is estimated that the region has 25.6% marine endemic species. Multiple uses have been found for both terrestrial and marine organisms of the Caribbean. Mass extinctions have occurred for Peoples, associated traditional knowledge, terrestrial and marine biodiversity. Sea level rise and increasing temperature are global problems that threaten this area. All this information cannot be covered in one chapter so this review, based on a wide range of publications including our own research, is to raise awareness of these issues and the need to know more while suggesting solutions for discussion.