The relevance of local ecological knowledge to conservation and development agendas is gaining momentum, and the Amazon biome features as one of the most promising areas for its empirical application. Considerable attention has been given to forest composition and Indigenous land use, while coastal and marine environments have only received cursory attention. Camboas de pedra is the name given by coastal communities in the Brazilian eastern Amazon to permanent intertidal fish weirs/traps constructed of local stones. The structures are singular features of the present day coastal landscape of São Luís Island (State of Maranhão). They are some of the most impressive evidence of the continued use of pre-Columbian Indigenous knowledge by rural communities in this region. Our deliberative and participatory study of the Camboas de pedra of the beaches of Panaquatira and Boa Viagem on São Luis Island revealed that the structures continue to provide both cultural and provision services to local users, playing a pivotal role in household food security and poverty alleviation in the eastern Amazon. Our results highlight the importance of integrating local users’ perceptions of heritage structures, both tangible and intangible, in order to design inclusive, equitable and sustainable conservation and fisheries management strategies.