This article summarises the sometimes controversial contributions made by the different sciences to predict the path of ocean acidification impacts on the diversity of coral reefs during the present century. Although the seawater carbonate system has been known for a long time, the understanding of acidification impacts on marine biota is in its infancy. Most publications about ocean acidification are less than a decade old and over half are about coral reefs. Contributions from physiological studies, particularly of coral calcification, have covered such a wide spectrum of variables that no cohesive picture of the mechanisms involved has yet emerged. To date, these studies show that coral calcification varies with carbonate ion availability which, in turn controls aragonite saturation. They also reveal synergies between acidification and the better understood role of elevated temperature. Ecological studies are unlikely to reveal much detail except for the observations of the effects of carbon dioxide springs in reefs. Although ocean acidification events are not well constrained in the geological record, recent studies show that they are clearly linked to extinction events including four of the five greatest crises in the history of coral reefs. However, as ocean acidification is now occurring faster than at any know time in the past, future predictions based on past events are in unchartered waters. Pooled evidence to date indicates that ocean acidification will be severely affecting reefs by mid century and will have reduced them to ecologically collapsed carbonate platforms by the century’s end. This review concludes that most impacts will be synergistic and that the primary outcome will be a progressive reduction of species diversity correlated with habitat loss and widespread extinctions in most metazoan phyla.