Madagascar is known for its high endemism and as many as 90% of this unique diversity are forest-dwellers. Unfortunately, the forest cover of Madagascar is decreasing at an alarming rate. This decrease can also affect aquatic insects, but our knowledge on aquatic insect diversity and distribution on Madagascar are limited. Although the eastern rainforests are considered the most diverse, the Central Highlands of Madagascar also harbors unique microendemic fauna but has been less studied. Here, we analyze the aquatic Adephaga beetle fauna of three remaining protected forests of the Central Highlands. Diversity, abundance, and uniqueness are compared between and within natural forests and surrounding grasslands. At least 15 undescribed species were found, highlighting the Central Highlands as an important area for endemism. The natural forests and the surrounding grasslands differed significantly in species assemblages. Interestingly, the three remaining forests differed in their assemblages with the geographically more distant Manjakatompo Ankaratra having the most unique fauna but also the highest altitude span. By contrast, the species composition was similar between the peripheral zones of each of the three remaining forests. The similarity of the fauna in the peripheral open habitats illustrates how some local forest endemics are replaced with widespread generalists in degraded habitats. Our study shows that the remaining forests of the Central Highlands of Madagascar are important refuges of unique fauna at high risk of extinction.