Declines in global coral reef health are primarily attributed to direct, tangible, and, most importantly, manageable human activities. The Belize Barrier Reef Reserve System was declared a UNESCO World Heritage Site due to its exceptional biodiversity and direct contribution to Belize’s economy through tourism and fisheries. It forms the heart of the Mesoamerican Reef (MAR), the largest continuous reef system in the western hemisphere. In the MAR region, reef health is threatened by invasive species, coastal development, overfishing, pollution and climate change. As one of seven marine protected areas comprising the UNESCO World Heritage Site, the management and reef health of Bacalar Chico Marine Reserve and National Park (BCMR and NP) is of particular relevance at local, national and international scales. In March 2010, Blue Ventures implemented a long-term coral reef monitoring plan. Results show that the majority of reefs within BCMR are in ‘poor’ or ‘critical’ condition when interpreted using the Simplified Integrated Reef Health Index (SIRHI), with depleted commercial fish populations and high fleshy macroalgal cover the primary cause for low site scores. There was no significant difference between management zones or outside the reserve for any of the key indicators (hard coral, fleshy macroalgae, commercial fish biomass and herbivorous fish biomass). As the management plan for BCMR was last revised in 2004, it is strongly recommended to the Belize Fisheries Department to prioritise reviewing and updating a management plan for BCMR and NP. Such a plan should reconsider the location of management zones, as they appear to be ineffective in maintaining ecological integrity of the reefs.