The widespread use of systemic neonicotinoid insecticides in agriculture results first in contamination of the soil of the treated crops, and secondly in the transfer of residues to the aquatic environment. The high toxicity of these insecticides to aquatic insects and other arthropods has been recognized, but there is little awareness of the impacts these chemicals have on aquatic environments and the ecosystem at large. Recent monitoring studies in several countries, however, have revealed a worldwide contamination of creeks, rivers and lakes with these insecticides, with residue levels in the low µg/L (ppb) range. The current extent of aquatic contamination by neonicotinoids is reviewed first, and the findings contrasted with the known acute and chronic toxicity of neonicotinoids to various aquatic organisms. Impacts on populations and aquatic communities, mostly using mesocosms, are reviewed next to identify the communities most at risk from those that undergo little or no impact. Finally, the ecological links between aquatic and terrestrial organisms are considered. The consequences for terrestrial vertebrate species that depend mainly on this food source are discussed together with impacts on ecosystem function. Gaps in knowledge stem from difficulties in obtaining long-term experimental data that relates the effects on individual organisms to impacts on populations and ecosystems. The paper concludes with a summary of findings and the implications they have for the larger ecosystem.