High densities of the corallivorous crown-of-thorns starfish (CoTS; Acanthaster sp.) have occurred throughout the Indo-Pacific often resulting in widespread coral loss. Whilst CoTS have previously been recorded at Barrow and the Montebello Islands, in the Pilbara offshore bioregion of northwestern Australia, their densities were relatively low. Outbreak densities of CoTS have been described as the level at which the rate of coral consumption by the starfish is equal to or greater than rate at which the coral grows. In 2014, we recorded densities as high as 320 ± 58 CoTS ha−1 in the region which is well above recognised outbreak densities. Whilst there is little terrestrial runoff and agriculture in the Pilbara region, both temperature and chlorophyll-α levels appear to be sufficient to allow a high degree of CoTS larval success in most years. The region was subjected to anomalously high water temperatures during the summers of 2010–2011 and particularly 2012–2013 which resulted in the mortality of almost 70% of live coral. We hypothesise that the high densities of CoTS observed are a result of CoTS responding to a reduced food supply and aggregating around the remaining live coral resulting in outbreak densities rather than a significant increase in the number of CoTS in the area. The small amount of remaining live coral is concentrated in a few areas and this, combined with high densities of CoTS in these areas, suggest that CoTS represent a significant threat to the recovery of the coral communities of the region.