To explore the impacts of increasing human numbers on nature, many studies have examined relationships between human population density (HPD) and biodiversity change. The implicit assumption in many of these studies is that as population density increases so does the threat to biodiversity. The implications of this assumption are compounded by recent research showing that species richness for many taxonomic groups is often highest in areas with high HPD. If increasing HPD is a threat to conservation, this threat may be magnified owing to the spatial congruence between people and species richness. Here, I review the relationships between HPD and measures of biodiversity status focussing in particular on evidence for the spatial congruence between people and species richness and the threat that increasing HPD may pose to biodiversity conservation. The review is split into two major sections: (i) a quantitative assessment of 85 studies covering 401 analyses, including meta-analyses on discrete relationships; and (ii) a discussion of the implications of the quantitative analyses and major issues raised in the literature.Our understanding of the relationships between HPD and biodiversity is skewed by geographic and taxonomic biases in the literature. Most research has been conducted in the Northern Hemisphere and focussed primarily on birds and mammals, largely ignoring relationships with other taxonomic groups. A total of 127 analyses compared HPD with the species richness of particular taxonomic groups. A meta-analysis of these results found a significant positive population correlation indicating that, on average, species-rich regions and human settlements co-occur. However, there was substantial unexplained heterogeneity in these data. Some of this heterogeneity was explained by the size of the sampling unit used by researchers – as this increased so did the strength of the correlation between HPD and species richness. The most convincing result for a taxonomic group was a significant positive population correlation between HPD and bird species richness. Significant positive population correlations were also found for HPD versus the richness of threatened and geographically restricted species. Hence, there is reasonably good evidence for spatial congruence between people and species-rich regions. The reasons for this congruence are only just beginning to be explored, but key mutual drivers appear to include available energy and elevation.The evidence for increasing HPD as a threat to conservation was weak, owing primarily to the extreme heterogeneity in the approaches used to address this issue. There was some suggestion of a positive relationship between HPD and species extinction, but this result should be interpreted with caution owing to the wide diversity of approaches used to measure extinction. Identifying strong links between human development and species extinction is hampered in part by the difficulty of recording extinction events. The most convincing indication of the negative impact of increasing HPD was a significant negative population correlation between density and the size of protected areas.The magnitude and implications of spatial congruence between people and biodiversity are now being explored using the principles of complementarity and irreplaceability. Human development as a threat to conservation is usually assessed within a complex, interdisciplinary modelling framework, although population size is still considered a key factor. Future population growth and expansion of human settlements will present increasing challenges for conserving species-rich regions and maximising the benefits humans gain from nature.