Sustainable management of intact tropical peatlands is crucial for climate change mitigation, for biodiversity conservation and to support the livelihoods of local communities. Here, we explore whether sustainable fruit harvesting from Mauritia flexuosa palms could support these linked goals by increasing fruit production and incomes across the 2.8 million hectares of the most carbon-dense ecosystem in Amazonia: the lowland peatlands of northeastern Peru. M. flexuosa is dioecious, and fruits are typically harvested by felling female palms; the proportion of female palms therefore provides a good indicator of the health of a stand. Across 93 widely distributed sites, we found that the proportion of female palms increases with travel time to the urban market, and overall, fruit harvesting has halved the current potential production and income from this resource. However, significantly more female palms are found where fruit are harvested by climbing. We estimate that region-wide uptake of climbing could eventually increase potential fruit production by 51% and increase its gross value to US$62 ± 28.2 million yr–1. These findings demonstrate the high cost of unsustainable resource extraction in Neotropical forests and outline a practical path to conserve and sustainably exploit one of the most carbon-rich landscapes on the planet.