In order to improve sustainability and design adequate management strategies in threatened tropical forests, integrated assessments of the use of ecosystem services are needed, combining biophysical, social, and economic approaches. In particular, no integrated ecosystem services (ES) assessment has been conducted in Central Africa, where rural communities deeply depend on forests in a high-poverty context. Here, we aimed to quantify the use of ES provided by tropical forests to local populations in the Dja area (Cameroon), identify its determinants and evaluate its sustainability. We conducted various interviews and field surveys with 133 households in three villages, focusing on three provisioning services (bushmeat, firewood, and timber), and five cultural services (cultural heritage, inspiration, spiritual experience, recreation, and education). Local populations consumed a mean of 56 kg of bushmeat/person/year (hunting zones covering on average 213 km2), 1.17 m3 of firewood/person/year (collection zones covering on average 4 km2), and 0.03 m3 of timber/person/year. Between 25% and 86% of respondents considered cultural services as important. The use of ES was mainly influenced by population size, deforestation rate, and forest allocations, whereas the influence of socio-demographic characteristics of households remained limited to slight differences between Baka and Bantu people. We conclude that the consumption of firewood and timber is sustainable, whereas high hunting pressure has resulted in severe defaunation in the area due to the large decline in the abundance and biomass of forest mammals hunted for bushmeat by local populations.