The removal of mesopredatory fishes by fishing may be a key factor driving outbreaks of crown-of-thorns starfish on coral reefs. Evidence for this idea has been derived from correlations between starfish densities and fishing pressure. However, dietary analyses using DNA, studies of the trophic role of mesopredatory fishes and experiments that have invoked threat responses suggest that outbreaks could also result from a trophic cascade driven, in part, by changes in the anti-predator behaviours of these fishes. If corroborated, this hypothesis could inform management decision-making, slowing the frequency of outbreaks and improving the health of coral reefs in the Anthropocene.