Understanding how Marine Protected Areas (MPAs) improve conservation outcomes across anthropogenic pressures can improve the benefits derived from them. Effects of protection for coral reefs in the western and central Indian Ocean were assessed using size-spectra analysis of fish and the relationships of trophic group biomass with human population density. Length-spectra relationships quantifying the relative abundance of small and large fish (slope) and overall productivity of the system (intercept) showed inconsistent patterns with MPA protection. The results suggest that both the slopes and intercepts were significantly higher in highly and well-protected MPAs. This indicates that effective MPAs are more productive and support higher abundances of smaller fish, relative to moderately protected MPAs. Trophic group biomass spanning piscivores and herbivores, decreased with increasing human density implying restoration of fish functional structure is needed. This would require addressing fisher needs and supporting effective MPA management to secure ecosystem benefits for coastal communities.