The early Paleogene experienced the most pronounced long-term warming trend of the Cenozoic, superimposed by transient warming events such as the Paleocene–Eocene Thermal Maximum (PETM). The consequences of climatic perturbations and associated changes on the evolution of carbonate platforms are relatively unexplored. Today, modern carbonate platforms, especially coral reefs are highly sensitive to environmental and climatic change, which raises the question how (sub)tropical reef systems of the early Paleogene reacted to gradual and sudden global warming, eutrophication of shelf areas, enhanced CO2 levels in an ocean with low Mg/Ca ratios. The answer to this question may help to investigate the fate of modern coral reef systems in times of global warming and rising CO2 levels. Here we present a synthesis of Tethyan carbonate platform evolution in the early Paleogene (~59–55 Ma) concentrating on coral reefs and larger foraminifera, two important organism groups during this time interval. We discuss and evaluate the importance of the intrinsic and extrinsic factors leading to the dissimilar evolution of both groups during the early Paleogene. Detailed analyses of two carbonate platform areas at low (Egypt) and middle (Spain) paleolatitudes and comparison with faunal patterns of coeval platforms retrieved from the literature led to the distinction of three evolutionary stages in the late Paleocene to early Eocene Tethys: Stage I, late Paleocene coralgal-dominated platforms at low to middle paleolatitudes; stage II, a transitional latest Paleocene platform stage with coralgal reefs dominating at middle paleolatitudes and larger foraminifera-dominated (Miscellanea, Ranikothalia, Assilina) platforms at low paleolatitudes; and stage III, early Eocene larger foraminifera-dominated (Alveolina, Orbitolites, Nummulites) platforms at low to middle paleolatitudes. The onset of the latter prominent larger foraminifera-dominated platform correlates with the Paleocene/Eocene Thermal Maximum. The causes for the change from coral-dominated platforms to larger foraminifera-dominated platforms are multilayered. The decline of coralgal reefs in low latitudes during platform stage II is related to overall warming, leading to sea-surface temperatures in the tropics beyond the maximum temperature range of corals. The overall low occurrence of coral reefs in the Paleogene might be related to the presence of a calcite sea. At the same time larger foraminifera started to flourish after their near extinction at the Cretaceous/Paleogene boundary. The demise of coralgal reefs at all studied paleolatitudes in platform stage III can be founded on the effects of the PETM, resulting in short-term warming, eutrophic conditions on the shelves and acidification of the oceans, hampering the growth of aragonitic corals, while calcitic larger foraminifera flourished. In the absence of other successful carbonate-producing organisms, larger foraminifera were able to take over the role as the dominant carbonate platform inhabitant, leading to a stepwise Tethyan platform stage evolution around the Paleocene/Eocene boundary. This scenario might be also effective for threatened coral reef sites.