Conservation can have both positive and negative effects on human well-being by causing changes in ecosystem service flows and reallocation of the distribution of benefits. This can lead to different, sometimes contradictory, outcomes of conservation. We studied local perceptions of ecosystem service flows in the Ranomafana National Park area of Madagascar to examine the local outcomes of conservation. The Ranomafana forest area provides a variety of benefits that contribute considerably to local inhabitants' livelihoods and well-being. Changes in ecosystem service flows alter the provision of many important ecosystem services at the local level, which is likely to affect local livelihoods negatively and increase local vulnerability and inequality. The findings indicate the presence of trade-offs between types of ecosystem services and between different societal goals, namely conservation and development. Benefit trade-offs also occur within and between beneficiary groups and across spatial and temporal scales. Although conservation might prove beneficial for local people in the long run, its immediate local costs are high. The findings reveal the importance of integrating local perceptions of ecosystem services into conservation planning. In addition, there is a need for further negotiations of the trade-offs between ecosystem services, conservation and development in Ranomafana.