Abstract The Ciénaga Grande of Santa Marta is Colombia's largest coastal wetland and one of the most important in the Caribbean. In this paper we evaluate the complex linkages existing among the social-ecological history, provision of ecosystem services and human well-being as perceived by local stakeholders. The most critical anthropogenic impacts occurred during the last 50 years in the period following the construction of the Ciénaga-Barranquilla highway. The changes to the social-ecological system have severely altered hydrological dynamics, reduced mangrove forest coverage and affected the composition of fisheries, with direct and indirect effects on the ecosystem services provision and on the well-being of the local people. Despite the ambitious restoration programmes put in practice during the last two decades, the social-ecological impacts of large infrastructure developments are visible today. The paper offers insights that can improve environmental decision making and promote adaptive governance in coastal wetlands. Editor Z.W. Kundzewicz; Guest editor M.C. Acreman Citation Vilardy, S.P., González, J.A., Martín-Lopez, B. and Montes, C., 2011. Relationships between hydrological regime and ecosystem services supply in a Caribbean coastal wetland: a social-ecological approach. Hydrological Sciences Journal, 56 (8), 1423–1435.