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Nature-based coastal protection is increasingly recognised as a potentially sustainable and cost-effective solution to reduce coastal flood risk. It uses coastal ecosystems such as mangrove forests to create resilient designs for coastal flood protection. However, to use mangroves effectively as a nature-based measure for flood risk reduction, we must understand the biophysical processes that govern risk reduction capacity through mangrove ecosystem size and structure. In this perspective, we evaluate the current state of knowledge on local physical drivers and ecological processes that determine mangrove functioning as part of a nature-based flood defence. We show that the forest properties that comprise coastal flood protection are well-known, but models cannot yet pinpoint how spatial heterogeneity of the forest structure affects the capacity for wave or surge attenuation. Overall, there is relatively good understanding of the ecological processes that drive forest structure and size, but there is a lack of knowledge on how daily bed-level dynamics link to long-term biogeomorphic forest dynamics, and on the role of combined stressors influencing forest retreat. Integrating simulation models of forest structure under changing physical (e.g. due to sea-level change) and ecological drivers with hydrodynamic attenuation models will allow for better projections of long-term natural coastal protection.