Ecosystem service (ES) trade-offs are central to informed decision-making, often requiring the prioritization of some ES over others. This comprehensive review synthesizes insights from over 3000 studies, identifying global patterns and research gaps across terrestrial, marine, and freshwater ecosystems. We highlight significant biases, including a predominant focus on terrestrial ecosystems and provisioning and habitat services, while cultural ES remain critically underrepresented. Regulating ES exhibit notable gaps in marine and freshwater contexts. Research is concentrated in Europe, Asia, and North America, whereas Africa exhibits a more balanced ES approach but remains underrepresented. A key insight is the limited integration of multiple ES categories, with most studies focusing on individual or paired services. Our dataset identifies underrepresented regions and emphasizes the need for region-specific approaches, particularly in marine and freshwater ecosystems. We advocate for interdisciplinary research, methodological transparency, and decision-support frameworks to bridge research gaps and foster equitable ES management.