Despite more than 60 yr of coral reef research using scuba diving, mesophotic coral ecosystems (MCEs) between 30 and 150 m depth remain largely unknown. This study represents the first underwater visual census of reef fish communities in the Greater Caribbean on MCEs at depths up to 80 m in Bermuda and 130 m in Curaçao. Sampling was performed using mixed-gas closed-circuit rebreathers. Quantitative data on reef fish communities were obtained for four habitats: coral reefs (45–80 m), rhodolith beds (45–80 m), ledges (85–130 m) and walls (85–130 m). A total of 38 species were recorded in Bermuda and 66 in Curaçao. Mesophotic reef fish communities varied significantly between the two localities. MCEs in Bermuda had lower richness and abundance, but higher biomass than those in Curaçao. Richness, abundance and biomass increased with depth in Bermuda, but decreased in Curaçao. A high turnover of species was found among depth strata and between Bermuda and other Caribbean upper MCEs (45–80 m), indicating that depth was an important driver of community structure at all localities. However, local and evolutionary factors (habitat and endemism) are likely the main factors shaping communities in isolated locations such as Bermuda. High fishing pressure is evident in both localities, as total biomass of apex predators was generally low, and thus may be driving a “refugia” scenario in Bermuda, as the abundance and biomass of macro-carnivores increased with depth and distance from the coast.