Coral reefs serve as natural barriers that protect adjacent shorelines from coastal hazards such as storms, waves, and erosion. Projections indicate global degradation of coral reefs due to anthropogenic impacts and climate change will cause a transition to net erosion by mid-century. Here, we provide a comprehensive assessment of the combined effect of all of the processes affecting seafloor accretion and erosion by measuring changes in seafloor elevation and volume for five coral reef ecosystems in the Atlantic, Pacific, and Caribbean over the last several decades. Regional-scale mean elevation and volume losses were observed at all five study sites and in 77 % of the 60 individual habitats that we examined across all study sites. Mean seafloor elevation losses for whole coral reef ecosystems in our study ranged from −0.09 to −0.8 m, corresponding to net volume losses ranging from 3.4  ×  10⁶ to 80.5  ×  10⁶ m³ for all study sites. Erosion of both coral-dominated substrate and non-coral substrate suggests that the current rate of carbonate production is no longer sufficient to support net accretion of coral reefs or adjacent habitats. We show that regional-scale loss of seafloor elevation and volume has accelerated the rate of relative sea level rise in these regions. Current water depths have increased to levels not predicted until near the year 2100, placing these ecosystems and nearby communities at elevated and accelerating risk to coastal hazards. Our results set a new baseline for projecting future impacts to coastal communities resulting from degradation of coral reef systems and associated losses of natural and socioeconomic resources.