Traffic emissions contribute significantly to the build-up of diffuse pollution loads on urban surfaces with their subsequent mobilisation and direct discharge posing problems for receiving water quality. This review focuses on the impact and mitigation of solids, metals, nutrients and organic pollutants in the runoff deriving from car parks. Variabilities in the discharged pollutant levels and in the potentials for pollutant mitigation complicate an impact assessment of car park runoff. The different available stormwater best management practices and proprietary devices are reported to be capable of reductions of between 20% and almost 100% for both suspended solids and a range of metals. This review contributes to prioritising the treatment options which can achieve the appropriate pollutant reductions whilst conforming to the site requirements of a typical car park. By applying different treatment scenarios to the runoff from a hypothetical car park, it is shown that optimal performance, in terms of ecological benefits for the receiving water, can be achieved using a treatment train incorporating permeable paving and bioretention systems. The review identifies existing research gaps and emphasises the pertinent management practices as well as design issues which are relevant to the mitigation of car park pollution.