Policy-makers are paying increasing attention to ecosystem services, given improved understanding that they underpin human well-being, and following their integration within the Aichi Targets of the Convention on Biological Diversity. Decision-makers need information on trends in biodiversity and ecosystem services but tools for assessing the latter are often expensive, technically demanding and ignore the local context. In this study we used a simple, replicable participatory assessment approach to gather information on ecosystem services at important sites for biodiversity conservation in Nepal, to feed into local and national decision-making. Through engaging knowledgeable stakeholders we assessed the services delivered by Nepal's 27 Important Bird and Biodiversity Areas, the pressures affecting services through impacts on land cover and land use, and the consequences of these for people. We found that these sites provide ecosystem services to beneficiaries at a range of scales but under current pressures the balance of services will change, with local communities incurring the greatest costs. The approach provided valuable information on the trade-offs between ecosystem services and between different people, developed the capacity of civil society to engage in decision-making at the local and national level, and provided digestible information for Nepal's government. We recommend this approach in other countries where there is a lack of information on the likely impacts of land-use change on ecosystem services and people.