High-latitude coral reefs may be a refuge and area of reef expansion under climate change. As these locations are expected to become dryer and as livestock and agricultural yields decline, coastal populations may become increasingly dependent on marine resources. To evaluate this social-ecological conundrum, we examined the Grand Récif of Toliara (GRT), southwest Madagascar, which was intensively studied in the 1960s and has been highly degraded since the 1980s. We analyzed the social and ecological published and unpublished literature on this region and provide new data to assess the magnitude of the changes and evaluate the causes of reef degradation. Top-down controls were identified as the major drivers: human population growth and migrations, overfishing, and climate change, specifically decreased rainfall and rising temperature. Water quality has not changed since originally studied, and bottom-up control was ruled out. The identified network of social-ecological processes acting at different scales implies that decision makers will face complex problems that are linked to broader social, economic, and policy issues. This characterizes wicked problems, which are often dealt with by partial solutions that are exploratory and include inputs from various stakeholders along with information sharing, knowledge synthesis, and trust building. A hybrid approach based on classical fishery management options and preferences, along with monitoring, feedback and forums for searching solutions, could move the process of adaptation forward once an adaptive and appropriately scaled governance system is functioning. This approach has broad implications for resources management given the emerging climate change and multiple social and environmental stresses.