Lion Panthera leo populations and distributions in Africa have contracted considerably in the past 30 years. Recent policy debates focus on restricting trophy hunting as a measure to address concerns about excessive offtakes of lions. We review the impact of trophy hunting in relation to lion conservation goals, using comparative case studies from Southern and East Africa, which together contain most of Africa's remaining lion populations. The comparison demonstrates that the impact of trophy hunting on lion populations is variable and shaped by the way trophy hunting is managed and wildlife is governed in different range states. In Tanzania, the most important lion range state, hunting produces significant revenues but weaknesses in how hunting is managed and revenues are distributed undermine the potential of hunting and encourage overharvesting. In Southern Africa linkages are stronger between revenue generated by trophy hunting and lion conservation outcomes on private and communal lands. Trophy hunting is most beneficial to lion conservation where revenues and user rights over wildlife are devolved, ensuring benefits from lion hunting compensate for their costs to local people, and where hunting is managed through long-term and competitively allocated concession systems. Policy interventions should focus on supporting trophy hunting as a conservation tool where it is effective and well-managed, and work to promote reform of hunting and wildlife governance elsewhere.