The large number of marine protected areas (MPAs) in the Caribbean (over 100) gives a misleading impression of the amount of protection the reefs and other marine resources in this region are receiving. This review synthesizes information on marine resources in two of the first MPAs established in the USA, namely Virgin Islands National Park (1962) and Buck Island Reef National Monument (1961), and provides compelling evidence that greater protection is needed, based on data from some of the longest running research projects on coral reefs, reef fish assemblages, and seagrass beds for the Caribbean. Most of the stresses affecting marine resources throughout the Caribbean (e.g. damage from boats, hurricanes and coral diseases) are also causing deterioration in these MPAs. Living coral cover has decreased and macroalgal cover has increased. Seagrass densities have decreased because of storms and anchor damage. Intensive fishing in the US Virgin Islands has caused loss of spawning aggregations and decreases in mean fish size and abundance. Groupers and snappers are far less abundant and herbivorous fishes comprise a greater proportion of samples than in the 1960s. Effects of intensive fishing are evident even within MPA boundaries. Although only traditional fishing with traps of ‘conventional design’ is allowed, commercial trap fishing is occurring. Visual samples of fishes inside and outside Virgin Islands National Park showed no significant differences in number of species, biomass, or mean size of fishes. Similarly, the number of fishes per trap was statistically similar inside and outside park waters. These MPAs have not been effective because an unprecedented combination of natural and human factors is assaulting the resources, some of the greatest damage is from stresses outside the control of park managers (e.g. hurricanes), and enforcement of the few regulations has been limited. Fully functioning MPAs which prohibit fishing and other extractive uses (e.g. no-take marine reserves) could reverse some of the degradation, allowing replenishment of the fishery resources and recovery of benthic habitats.