The southwest Indian Ocean (SWIO) is a hotspot of endemic and evolutionarily distinct sharks and rays. We summarise the extinction risk of the sharks and rays endemic to coastal, shelf, and slope waters of the SWIO (Namibia to Kenya, including SWIO islands). Thirteen of 70 species (19%) are threatened: one is Critically Endangered, five are Endangered, and seven are Vulnerable. A further seven (10%) are Near Threatened, 33 (47.1%) are Least Concern, and 17 (24.2%) are Data Deficient. While the primary threat is overfishing, there are the first signs that climate change is contributing to elevated extinction risk through habitat reduction and inshore distributional shifts. By backcasting their status, few species were threatened in 1980, but this changed soon after the emergence of targeted shark and ray fisheries. South Africa has the highest national conservation responsibility, followed by Mozambique and Madagascar. Yet, while fisheries management and enforcement have improved in South Africa over recent decades, drastic improvements are urgently needed elsewhere. To avoid extinction and ensure robust populations and future food security, there is an urgent need for the strict protection of Critically Endangered and Endangered species and sustainable management of all species, underpinned by species-level data collection and bycatch reduction.