Reef flats, typically a low-relief carbonate and sand habitat in shallow water leeward of the reef crest, are one of the most extensive zones on Pacific coral reefs. This shallow zone often supports an abundant and diverse fish assemblage that is exposed to more significant variations in physical factors, such as water depth and movement, temperature and ultraviolet (UV) radiation levels, than most other reef fishes. This review examines the characteristics of reef flat fish assemblages, and then investigates what is known about how they respond to their biophysical environment. Because of the challenges of living in shallow, wave-exposed water, reef flats typically support a distinct fish assemblage compared to other reef habitats. This assemblage clearly changes across tidal cycles as some larger species migrate to deeper water at low tide and other species modify their behaviour, but quantitative data are generally lacking. At least some reef flat fish species are well-adapted to high temperatures, low oxygen concentrations and high levels of UV radiation. These behavioural and physiological adaptations suggest that there may be differences in the demographic processes between reef flat assemblages and those in deeper water. Indeed, there is some evidence that reef flats may act as nurseries for some species, but more research is required. Further studies are also required to predict the effects of climate change, which is likely to have multifaceted impacts on reef flats by increasing temperature, water motion and sediment load. Sea-level rise may also affect reef flat fish assemblages and food webs by increasing the amount of time that larger species are able to forage in this zone. The lack of data on reef flats is surprising given their size and relative ease of access, and a better understanding of their functional role within tropical marine seascapes is urgently required.