The need to reduce human impacts on ecosystems creates pressure for adequate response, but the rush to solutions fosters the oversimplification of such notions as sustainable development and ecosystem health. Hence, it favors the tendency to ignore the complexity of natural systems. In this paper, after a brief analysis of the use and abuse of the notion of ecosystem health, we address the problem of a sound definition of ecosystem integrity, critically review the different methodological and conceptual approaches to the management of natural resources, and sketch the practical implications stemming from their implementation. We show thatthere are merits and limitations in different definitions of ecosystem integrity, for each acknowledges different aspects of ecosystem structure and functioning and reflects the subjective perspectives of humans on the value, importance, and role of biological diversity. This evaluation is based on a brief sketch of the links among biodiversity, ecosystem functioning and resilience, and a description of the problems that arise in distinguishing between natural and anthropogenic disturbance. We also emphasize the difficulty of assessing the economic value of species and habitats and the need to use adaptive management policies to deal with uncertainty and ecosystem complexity. In conclusion, while acknowledging that environmental legislation requires objective statements on ecosystem status and trends, we stress that the notion of ecological integrity is so complex that its measure cannot be expressed through a single indicator, but rather requires a set of indicators at different spatial, temporal, and hierarchical levels of ecosystem organization. Ecosystem integrity is not an absolute, monolithic concept. The existence of different sets of values regarding biological diversity and environmental risks must be explicitly accounted for and incorporated in the decision process, rather than ignored or averaged out.