This paper assesses damage to diving sites off Hurghada and Safaga, Egypt, and examines management responses and options. Data were obtained using the line-intercept-transect method. Using general field observations, a control site comparison and a historical comparison, it was found that the four diving sites studied suffered varying degrees of physical damage and needed management attention. Some transect locations had experienced severe physical damage while others had escaped damage. The most obvious difference between the control site and the four damaged sites (at both 4 and 8 m depths) was the consistently high percentage cover of hard coral (especially Acropora coral) and low percentage cover of soft corals among all transects at the Giftun Canal control site. Total algae percentages were also consistently higher at impacted transect sites versus the control site. From a historical perspective, at the Small Giftun site from 1987 to 1996, percentage hard coral cover decreased by 43% and algal cover increased over fourfold. If the diving tourism industry is to sustain itself in the Egyptian Red Sea, every management effort must be made to minimise controllable sources of stress on the coral reef system. Dive site management programme options, based on peer-reviewed carrying capacity research and stakeholder involvement, are reviewed.