The article presents an updated assessment of nutrient-related impacts in US estuaries, conducted in 2007. The assessment evaluates three components for each estuary: influencing factors (e.g., land use, nutrient loads), overall eutrophic condition (e.g., chlorophyll $a$, nuisance/toxic algae, 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 levels of problems, particularly in the mid-Atlantic region. Human-related activities, such as agriculture, wastewater treatment, and urban runoff, are major contributors to nutrient loads. Conditions are predicted to worsen in 65% of assessed estuaries and improve in 19%. Analysis of changes from the early 1990s to the early 2000s shows that conditions mostly remained the same, though some systems improved or worsened. Chlorophyll $a$ and harmful algal blooms (HABs) have increased in the mid-Atlantic region, more prevalent in systems with longer residence times. Successful seagrass restoration in Tampa Bay is encouraging but future management will be challenging. The overall positive trend in the assessment highlights the need for coordinated and integrated actions, including management, monitoring, research, and community engagement.The article presents an updated assessment of nutrient-related impacts in US estuaries, conducted in 2007. The assessment evaluates three components for each estuary: influencing factors (e.g., land use, nutrient loads), overall eutrophic condition (e.g., chlorophyll $a$, nuisance/toxic algae, 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 levels of problems, particularly in the mid-Atlantic region. Human-related activities, such as agriculture, wastewater treatment, and urban runoff, are major contributors to nutrient loads. Conditions are predicted to worsen in 65% of assessed estuaries and improve in 19%. Analysis of changes from the early 1990s to the early 2000s shows that conditions mostly remained the same, though some systems improved or worsened. Chlorophyll $a$ and harmful algal blooms (HABs) have increased in the mid-Atlantic region, more prevalent in systems with longer residence times. Successful seagrass restoration in Tampa Bay is encouraging but future management will be challenging. The overall positive trend in the assessment highlights the need for coordinated and integrated actions, including management, monitoring, research, and community engagement.