This report presents a synthesis and integration of the ndings of the four MA Working Groups (Condition and Trends, Scenarios, Responses, and Sub-global Assessments). It does not, however, provide a comprehensive summary of each Working Group report, and readers are encouraged to also review the ndings of these separately. This synthesis is organized around the core questions originally posed to the assessment: How have ecosystems and their services changed? What has caused these changes? How have these changes affected human well-being? How might ecosystems change in the future and what are the implications for human well-being? And what options exist to enhance the conservation of ecosystems and their contribution to human well-being?