The prevalence of scars and wounds of anthropogenic origin was assessed in seven different coastal bottlenose dolphin communities (Tursiops truncatus) on the south-western coast of Ecuador. Between 2011 and 2017 a total of 117 trips were conducted representing a total sampled distance of 6281 km. Twenty-five of the 189 (13.2%) free-ranging photo-identified dolphins were recorded with dorsal fin damage, V-shaped wounds, sawed edges and deformities in the caudal region. The scarring prevalence ranged from 0 to 44.4% and was associated with either fishing interactions or vessel strikes. Dolphin scarring increased five times in the last 25 years from 2.2 to 11.1% and was correlated with a decrease in population in the inner estuary of the Gulf of Guayaquil. Damaged dorsal fins are associated mainly with fishing gear. V-shaped wounds were recorded in three different communities, Posorja, Estero Salado and Salinas, and given their severity associated with either fishing gear or vessel strikes. During the study period three dolphins were found entangled in fishing gears, two in gillnets and one in a long-line, emphasizing the threats posed by current fishing practice to the species. More effective management measures are urgently needed to reverse the observed population decline. This may include reduction of fishing effort, implementation of area-based approaches to coastal planning (including Marine Protected Area designations) and support for further research to understand the problem. Given the difficulty in taking direct observations, scarring prevalence is proposed as a proxy for estimating boat traffic and fishing gear impacts upon cetaceans.