Discussions of sustainable use have become polarized. Welfarists oppose all use that involves killing animals. Among conservationists polarization arises in part from failure to distinguish between different ideas nestled under the umbrella term of ‘sustainable use’. These include direct use as an imperative or choice, the ideal of keeping any use within biologically sustainable limits, and use as a possible conservation strategy that can create positive incentives, which are key where land could otherwise be converted to biodiversity-unfriendly practices. People will continue to use wild living resources, which increasing human populations could further deplete. In response the conservation community can follow one of two approaches. On the one hand, it can try to stop use through the establishment of strictly protected areas and by enforcing legislation, although many would question the ethical position of imposing such an approach. On the other hand, it can work to introduce the wider management systems needed to deliver sustainable use and, if possible, incentive-driven conservation. Because most rural populations will continue using wild living resources in human-dominated landscapes, sustainable use and incentive-driven conservation should both be at the centre of the conservation agenda this century. Both species- and ecosystem-based management are likely to have a role in sustainable use. However, current enthusiasm for the ecosystem approach may throw up unexpected consequences, making the search for sustainability even more polarized. Nevertheless, direct use of species cannot provide sufficient incentives to ensure the continued delivery of ecosystem services, which need to be fully incorporated in the global accounting system.