Debate about what proportion of the Earth to protect often overshadows the question of how nature should be conserved and by whom. We present a systematic review and narrative synthesis of 169 publications investigating how different forms of governance influence conservation outcomes, paying particular attention to the role played by Indigenous peoples and local communities. We find a stark contrast between the outcomes produced by externally controlled conservation, and those produced by locally controlled efforts. Crucially, most studies presenting positive outcomes for both well-being and conservation come from cases where Indigenous peoples and local communities play a central role, such as when they have substantial influence over decision making or when local institutions regulating tenure form a recognized part of governance. In contrast, when interventions are controlled by external organizations and involve strategies to change local practices and supersede customary institutions, they tend to result in relatively ineffective conservation at the same time as producing negative social outcomes. Our findings suggest that equitable conservation, which empowers and supports the environmental stewardship of Indigenous peoples and local communities represents the primary pathway to effective long-term conservation of biodiversity, particularly when upheld in wider law and policy. Whether for protected areas in biodiversity hotspots or restoration of highly modified ecosystems, whether involving highly traditional or diverse and dynamic local communities, conservation can become more effective through an increased focus on governance type and quality, and fostering solutions that reinforce the role, capacity, and rights of Indigenous peoples and local communities. We detail how to enact progressive governance transitions through recommendations for conservation policy, with immediate relevance for how to achieve the next decade’s conservation targets under the UN Convention on Biological Diversity.