Synonymies, diagnoses, descriptions, illustrations, and spot distribution maps are given for ten species of Opistognathus, including all western Atlantic species that have a cirrus on their anterior nostrils. Three deep-water species lacking nasal cirri are also treated, including O. leprocarus n. sp. (Bahamas and Lesser Antilles), O. melachasme (Yucatan), and O. nothus n. sp. (North Carolina, Gulf of Mexico and Cuba); the latter two species were originally thought to represent different sexes of the same species. The O. macrognathus species group is diagnosed primarily by having sexually dimorphic jaws and sexually dichromatic maxillary markings, and includes the eastern Pacific O. scops and the following five western Atlantic species: O. macrognathus (Florida, Gulf of Mexico, and Bahamas to northern South America), O. brasiliensis n. sp. (southern Brazil), O. cuverii (southern Brazil), O. robinsi n. sp. (South Carolina, Florida, Bahamas, and Gulf of Mexico), and O. signatus n. sp. (Nicaragua, Panama, and northern South America). Opistognathus robinsi and O. signatus are very similar morphologically and here recognized as allopatric sister-species but the possibility exists that their disjunct continental distributions may be a collecting artifact. The broadly distributed and shallow-water species Opistognathus whitehurstii and O. maxillosus are superficially similar to some members of the O. macrognathus species group, including having cirri on their anterior nostrils, but differ most obviously in having non-sexually dimorphic jaws and more numerous cephalic sensory pores. An identification key is provided for all known western Atlantic species of Opistognathus.