ABSTRACT: Dramatic declines in populations of the eastern oyster Crassostrea virginica are a symptom of degradation in many US Atlantic and Gulf of Mexico estuaries. We sampled 94 oyster reefs (88 constructed, 6 natural) within 11 no-harvest sanctuaries in estuaries of central and northern North Carolina, USA, to evaluate the success of oyster sanctuaries as a conservation tool. The sanctuaries have been in existence from 3 to 30 yr; 10 sanctuaries protect constructed (‘restored’) oyster reefs and 1 sanctuary protects natural reefs. Measurements of vertical relief, live oyster density, recruitment, abundance of market-sized oysters, and biomass as well as disease prevalence and severity indicated that 7 of the 11 sanctuaries met criteria for minimal success by having vertical relief >20 cm in height, living oysters (>10 oysters m–2), and evidence of recent recruitment in 1 of 2 yr of the survey. Most reefs within the 7 sanctuaries far surpassed these relatively low benchmarks. For reefs that failed, burial by sedimentation appeared to be the primary cause in 2 sanctuaries, poor water quality (low dissolved oxygen) in 1, and poor oyster recruitment in another. All intertidal reefs were successful and had significantly higher densities of all size categories of live oysters (spat, adult, marketable size) than subtidal oyster reefs. Disease prevalence and severity were low in sanctuary reefs despite high oyster densities and increased longevity of oysters on these reefs. Pronouncements that restoration of the native eastern oyster is a failure prove incorrect when a decade-long history of oyster reef sanctuaries is evaluated. The proposed introduction of a non-native oyster into the US Atlantic coast estuaries cannot be justified by claiming failure of native oyster restoration in light of promising successes within sanctuaries.