This Special Issue focuses on eutrophication and related ecological health risks—one of the biggest challenges to sustainable water management. It is increasingly recognized that eutrophication has multidimensional consequences for water quality, both ecosystem and human health, as well as economic activities. These consequences depend on site-specific conditions, specifically, the ecological stability of the system, land use types, climate change, and the presence of other contaminants, including infectious disease agents. This Special Issue contains ten research papers that focus on, among other factors, phosphorus, cyanobacteria, off-flavor substances, macroinvertebrates, chemical stress, and land-use effects, thereby increasing our understanding of the multidimensional effects of eutrophication.