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Wildlife exploitation has nutritional, medicinal, luxury, sociocultural, and financial significance for human societies. Yet, it also risks undesired outcomes for conservation, animal welfare, and public health. Although it is prohibited in urban markets, the wildlife trade in Peru is poorly monitored, and practiced openly. To identify those species most likely to be affected, we investigated the trade in live wild animals and their derivatives at the Belen Market, and additional smaller open-air markets, which together make Iquitos the largest and most important wildlife trade hubs in the Peruvian Amazon. Specifically, we asked what wild animals or animal products were most profitable, what were they used for, and which wild animals were perceived by vendors to have increased most in rarity. Vendors provided 44 local animal names, from which we inferred an estimated 205 species. Nine per cent (n = 19) of these inferred species are categorised on the IUCN Red List as threatened; 35% (n = 71) are categorised as declining. We found that wild meat/food was the most frequently stated purpose of sale of wildlife, followed by pets, spiritual/belief-based use, traditional medicine, and decorative use. The most commonly cited most profitable wildlife derivatives were ‘lowland paca’, ‘yellow footed tortoise’, and ‘collared peccary’. A significant positive correlation was found between the most profitable species and those that are becoming increasingly rare. Further research focused on the actual impacts on wildlife, the socio-economic importance of this trade, the societal pressures driving consumer demand, and the risks to public health is warranted.