The knowledge, values, and practices of Indigenous peoples and local communities offer ways to understand and better address social-environmental problems. The article reviews the state of the literature on this topic by focusing on six pathways by which Indigenous peoples and local communities engage with management of and relationships to nature. These are ( a) undertaking territorial management practices and customary governance, ( b) contributing to nature conservation and restoration efforts with regional to global implications, ( c) co-constructing knowledge for assessments and monitoring, ( d) countering the drivers of unsustainable resource use and resisting environmental injustices, ( e) playing key roles in environmental governance across scales, and ( f) offering alternative conceptualizations of the interrelations between people and nature. The review shows that through these pathways Indigenous peoples and local communities are making significant contributions to managing the health of local and regional ecosystems, to producing knowledge based in diverse values of nature, confronting societal pressures and environmental burdens, and leading and partnering in environmental governance. These contributions have local to global implications but have yet to be fully recognized in conservation and development polices, and by society at large.