Among the world‘s ecosystems, estuaries have the highest total economic value per hectare. They are dynamic coastal biomes that provide a host of different goods and services to the surrounding terrestrial and aquatic environments and the people who utilise them. These goods and services include, inter alia, nursery areas for marine organisms, harvested natural resources (such as fish, shell-fish, bait organisms, reeds and mangroves), flood attenuation, water purification, nutrient and sediment sinks, waste disposal, transport, aesthetic beauty and areas for swimming, boating and fishing. Assessing the condition of estuaries is difficult as their state can change depending on what is being measured. Assessments have been carried out on the health of estuaries in South Africa with the results of these studies being used as inputs to the process of assessing the minimum water supply requirements for each estuary (ecological reserve) in order to maintain or improve its functionality. These ecological reserve requirements are assigned using Resource Directed Measures (RDM). These measures, however, have been criticised for being highly complex and too costly to implement for all South African estuaries within a reasonable time period. Another concern is that the levels of demand for recreational goods and services provided by the estuary are not taken into account when assessing estuarine value. It is important to understand that the use of estuaries for recreational purposes is inextricably linked to their health and sound ecological functioning. Although South African estuaries have been quite well buffered from impacts until only very recently, their use and pressures have escalated faster than what conservation authorities and policy makers have been prepared for over the last couple of decades. There is thus mounting pressure on estuaries as recreational outlets, which, in turn, has led to their functional deterioration as well as deterioration in the quality of the recreational experience as a whole. One implication for management is that more and more trade-offs have to be made in an attempt to balance the conservation and recreational use of estuaries.