Nowadays, environmental fatigue assessment is mandatory in many countries, in the design and operational stages of nuclear structural components. The analysis of environmental fatigue can be a complex engineering process that is generally performed following national or international procedures. Such procedures are not always based on the same assumptions, and novel analysts may find a confusing variety of documents. Moreover, once a specific procedure has been chosen for the analysis, it is possible to complete the fatigue assessment by using design transients (and loads) or, alternatively, real loads provided by monitoring systems. In this context, this paper provides a comprehensive review of the different environmental fatigue assessment procedures and a brief description of the different types of load inputs (design vs. real data). The work is completed with a case study, in which the (fatigue) cumulative usage factor is estimated in a particular nuclear component by using one of the abovementioned assessment procedures (NUREG/CR-6909) and two options for the load inputs.