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Ecosystem services can provide a wide range of benefits for human well-being, including provisioning, regulating and cultural services and benefitting both private and public interests in different sectors of society. Biophysical, economic and social factors all make it unlikely that multiple needs will be met simultaneously without deliberate efforts, yet while there is still much interest in developing win-win outcomes there is little understanding of what is required for them to be achieved. We analysed outcomes in a wide range of case studies where ecosystem services had been used for human well-being. Using systematic mapping of the literature from 2000 to 2013, we identified 1324 potentially relevant reports, 92 of which were selected for the review, creating a database of 231 actual or potential recorded trade-offs and synergies. The analysis of these case studies highlighted significant gaps in the literature, including: a limited geographic distribution of case studies, a focus on provisioning as opposed to non-provisioning services and a lack of studies exploring the link between ecosystem service trade-offs or synergies and the ultimate impact on human well-being. Trade-offs are recorded almost three times as often as synergies and the analysis indicates that there are three significant indicators that a trade-off will occur: at least one of the stakeholders having a private interest in the natural resources available, the involvement of provisioning ecosystem services and at least one of the stakeholders acting at the local scale. There is not, however, a generalisable context for a win-win, indicating that these trade-off indicators, although highlighting where a trade-off may occur do not indicate that it is inevitable. Taking account of why trade-offs occur (e.g. from failures in management or a lack of accounting for all stakeholders) is more likely to create win-win situations than planning for a win-win from the outset. Consequently, taking a trade-offs as opposed to a win-win approach, by having an awareness of and accounting for factors that predict a trade-off (private interest, provisioning versus other ES, local stakeholder) and the reasons why trade-offs are often the outcome, it may be possible to create the synergies we seek to achieve.