Knowledge of factors that are important in reef resilience and integrity help us understand how reef ecosystems react following major anthropogenic and environmental disturbances. The North Jamaican fringing reefs have shown some recent resilience to acute disturbances from hurricanes and bleaching, in addition to the recurring chronic stressors of over-fishing and land development. Factors that can improve coral reef resilience are reviewed, and reef rugosity is shown to correlate with coral cover and growth, particularly for branching Acropora species. The biodiversity index for the Jamaican reefs was lowered after the 2005 mass bleaching event, as were the numbers of coral colonies, but both had recovered by 2009. The importance of coastal zone reef management strategies and the economic value of reefs are discussed, and a protocol is suggested for future management of Jamaican reefs.