We use the formulation of conformal higher spin (CHS) theories in twistor space to study their tree-level scattering amplitudes, finding expressions for all three-point MHV mplitudes and all MHV amplitudes involving positive helicity conformal gravity particles and two negative helicity higher spins. This provides the on-shell analogue for the covariant coupling of CHS fields to a conformal gravity background. We discuss the restriction of the theory to a ghost-free unitary subsector, analogous to restricting conformal gravity to general relativity with a cosmological constant. We study the flat-space limit and show that the restricted amplitudes vanish, supporting the conjecture that in the unitary sector the S-matrix of CHS theories is trivial. However, by appropriately rescaling the amplitudes we find non-vanishing results which we compare with chiral flat-space higher spin theories.