Caribbean coral reefs are declining faster than current restoration and management approaches can keep pace, making more adaptive and coordinated interventions essential. This policy brief synthesizes insights from the 2024 Reef Futures workshop “Co-designing a future for Caribbean reefs”, where practitioners, researchers, and managers assessed the efficacy and risks of emerging coral reef interventions and discussed what is feasible under current governance conditions. While several approaches—such as managed breeding, grazer supplementation, and feeding supplementation—are viewed as ready for responsible use, progress is limited less by technical capacity and more by slow permitting processes, fragmented cross-border coordination, and risk-averse institutional cultures. The brief outlines four priority actions: creating pre-approved pathways for urgent interventions; harmonizing regional governance for genetic exchange under emerging frameworks like “One Caribbean”; investing in intermediary organizations that connect science, practice, and policy; and reframing risk management to support adaptive learning through carefully designed trials. These recommendations provide a practical path for more timely, climate-resilient coral reef interventions across the Caribbean.