The present study reports the results of the first quantitative survey of lesions on coral and crustose coralline algae (CCA) on reefs in the lagoon of New Caledonia. Surveys on inshore and offshore reefs were conducted at 13 sites in 2010, with 12 sites resurveyed in 2013. Thirty coral diseases affecting 15 coral genera were found, with low overall disease prevalence (<1%). This study extends the known distribution of growth anomalies to the coral genera Platygyraand Hydnophora, endolithic hypermycosis to Platygyra, Leptoria and Goniastrea and extends the geographic range of three CCA diseases. We found the first trematode infection in Porites outside of Hawaii. Disease prevalence differed among coral genera, with Porites having more lesions, and Acropora and Montipora fewer lesions, than expected on the basis of field abundance. Inshore reefs had a lower coral-colony density, species diversity and reduced CCA cover than did the offshore reefs. Disease prevalence was significantly higher on inshore reefs in 2013 than in 2010, but did not change on offshore reefs. The potential ecological impact of individual coral diseases was assessed using an integrative-scoring and relative-ranking scheme based on average frequency of occurrence, prevalence and estimated degree of virulence. The top-five ranked diseases were all tissue-loss diseases.