Coral reefs exist in a delicate balance between calcium carbonate (CaCO3) production and CaCO3 loss. Ocean acidification (OA), the CO2-driven decline in seawater pH and CaCO3 saturation state (Ω), threatens to tip this balance by decreasing calcification and increasing erosion and dissolution. While multiple CO2 manipulation experiments show coral calcification declines under OA, the sensitivity of bioerosion to OA is less well understood. Previous work suggests that coral and coral-reef bioerosion increase with decreasing seawater Ω. However, in the surface ocean, Ω and nutrient concentrations often covary, making their relative influence difficult to resolve. Here, we exploit unique natural gradients in Ω and nutrients across the Pacific basin to quantify the impact of these factors, together and independently, on macrobioerosion rates of coral skeletons. Using an automated program to quantify macrobioerosion in three-dimensional computerized tomography (CT) scans of coral cores, we show that macrobioerosion rates of live Porites colonies in both low-nutrient (oligotrophic) and high-nutrient (>1 µM nitrate) waters increase significantly as Ω decreases. However, the sensitivity of macrobioerosion to Ω is ten times greater under high-nutrient conditions. Our results demonstrate that OA (decreased Ω) alone can increase coral macrobioerosion rates, but the interaction of OA with local stressors exacerbates its impact, accelerating a shift toward net CaCO3 removal from coral reefs.