Adaptive Management (AM) is widely considered to be the best available approach for managing biological systems in the presence of uncertainty. But AM has arguably only rarely succeeded in improving biodiversity outcomes. There is therefore an urgent need for reflection regarding how practitioners might overcome key problems hindering greater implementation of AM. In this paper, we present the first structured review of the AM literature that relates to biodiversity and ecosystem management, with the aim of quantifying how rare AM projects actually are. We also investigated whether AM practitioners in terrestrial and aquatic systems described the same problems; the degree of consistency in how the term ‘adaptive management’ was applied; the extent to which AM projects were sustained over time; and whether articles describing AM projects were more highly cited than comparable non-AM articles. We found that despite the large number of articles identified through the ISI web of knowledge (n = 1336), only 61 articles (<5%) explicitly claimed to enact AM. These 61 articles cumulatively described 54 separate projects, but only 13 projects were supported by published monitoring data. The extent to which these 13 projects applied key aspects of the AM philosophy - such as referring to an underlying conceptual model, enacting ongoing monitoring, and comparing alternative management actions - varied enormously. Further, most AM projects were of short duration; terrestrial studies discussed biodiversity conservation significantly more frequently than aquatic studies; and empirical studies were no more highly cited than qualitative articles. Our review highlights that excessive use of the term ‘adaptive management’ is rife in the peer-reviewed literature. However, a small but increasing number of projects have been able to effectively apply AM to complex problems. We suggest that attempts to apply AM may be improved by: (1) Better collaboration between scientists and representatives from resource-extracting industries. (2) Better communication of the risks of not doing AM. (3) Ensuring AM projects “pass the test of management relevance”.