Studies of multiple stressors in Africa often focus on vulnerable inland communities. Rising concentrations of the world’s poor live in coastal rural–urban areas with direct dependencies on marine as well as terrestrial ecosystem goods and services. Using participatory methods we elicited perceptions of stressors and their sources, impacts and consequences held by coastal communities in eastern Africa (Mtwara in Tanzania and Maputo in Mozambique). Respondent-informed timelines suggest wars, economic policies and natural increase have led to natural resource-dependent populations in marginal, previously little-inhabited lowland coastal areas. Respondents (n = 91) in interviews and focus groups rank climate stressors (temperature rise/erratic rain) highest amongst human/natural stressors having negative impacts on livelihoods and wellbeing (e.g., cross-scale cost of living increases including food and fuel prices). Sources of stress and impacts were mixed in time and space, complicating objective identification of causal chains. Some appeared to be specific to coastal areas. Respondents reported farms failing and rising dependence on stressed marine resources, food and fuel prices and related dependence on traders and credit shrunk by negative global market trends. Development in the guise of tourism and conservation projects limited access to land–sea livelihoods and resources in rural–urban areas (coastal squeeze). Mental modelling clarified resource user perceptions of complex linkages from local to international levels. We underline risks of the poor in marginal coastal areas facing double or multiple exposures to multiple stressors, with climate variability suggesting the risks of climate change.