Abstract: An updated assessment of nutrient related impacts in US estuaries was completed in 2007. This assessment evaluates three components for each estuary: the influencing factors (e.g. land use, nutrient loads), the overall eutrophic condition (e.g. chlorophyll a, presence of nuisance/toxic algae and macroalgae, extent of dissolved oxygen problems, loss of submerged aquatic vegetation), and future outlook. Eutrophication is a widespread problem with 65% of assessed systems showing moderate to high level problems. The most impacted region was the mid-Atlantic. The majority of estuaries assessed, with the exception of North Atlantic systems (Cape Cod north to Maine), are highly influenced by human related activities that contribute to land-based nutrient loads. Conditions were predicted to worsen in 65% and to improve in 19% of the assessed estuaries in the future. Analysis of the extent of change from the early 1990s to the early 2000s, for those systems for which sufficient data were available, shows that conditions mostly remained the same (32 of 58 systems) though changes were observed in several smaller systems; 13 systems improved and 13 systems worsened. Chlorophyll a and HAB impacts have increased in the mid-Atlantic region, the only region with data adequate for comparison. These symptoms are more prevalent in systems with longer residence times, such as coastal lagoons. The successful restoration of seagrass in Tampa Bay is encouraging though future management to sustain the recovery will be difficult given expected population increases. This national assessment illustrates the need for coordinated and integrated action that balances management action, efficient monitoring to assess the effectiveness of the management, focused research, and a communication campaign aimed at engaging the broader community.