In 2017, more than 15,000 scientists from 184 countries signed a second warning letter to humanity to caution against our continued wholesale destruction of global ecosystems (Ripple et al., 2017). Here, we reaffirm their message with a similar warning specifically focused on the ocean: humanity must immediately and significantly alter our harmful trajectory in order to avoid irrevocably damaging our oceans in multiple ways that will further affect ocean health for both us and future generations. The ocean is the world's largest realm, housing an astonishing array of biodiversity that provides critical ecological functions that ultimately support life on Earth. In this paper, we outline some of the significant ongoing and imminent activities that degrade ocean health, including destructive fishing practices, oil and natural gas extraction, seabed mining, coastal development, shipping, pollution, and greenhouse-gas emissions. We end by offering potential avenues to mitigate these impacts, including the cessation of particularly harmful activities, restoration of damaged habitats, strong protection of key and representative ecosystems, reduction in waste and emissions, and global policy shifts that prioritize ecosystem health.