Coastal realignment is the procedure of repositioning or removing coastal defense structures to restore tidal flooding and facilitate the development of intertidal ecosystems in a previously reclaimed area from the sea. A key policy objective of coastal realignment is to increase ecosystem services provided by intertidal ecosystems and thereby contribute to human well-being. However, the social response to coastal realignment is often negative, raising the question as to what extent communities living nearby project locations recognize, value and benefit from the goods and services provided by restored intertidal ecosystems. In this study, we examine public perceptions of ecosystem services gains, losses and trade-offs associated with coastal realignment. We hereby focus on three coastal realignment case study locations in the Southwest delta, the Netherlands. Questionnaires were administered in nearby villages and the collected data (N = 261) were analyzed using random forest regression models. A notable outcome of this study is that local communities often consider coastal realignment interventions to decrease rather than increase the availability of ecosystem services. This points to a discrepancy between how coastal realignment is viewed from a policy perspective and a local community perspective. Changes in the availability of cultural ecosystem services were found to have the highest impact on the level of support for coastal realignment, while the importance attached to provisioning, regulating and supporting ecosystem services was notably lower. In consequence, to increase public support, it will be essential to minimize the loss of cultural ecosystem services, or better yet, find ways to increase cultural ecosystem services through coastal realignment, for instance by creating opportunities for recreation and tourism.