The Northeast Pacific Ocean conjures images of tidal pools, migrating salmon, pods of killer whales and awe-inspiring grizzly bears. It also provides food, jobs and security to the people of the region, through fishing, trade and ecotourism. However, the diverse ecosystems of the Northeast Pacific face tremendous pressures, as both local and global stressors threaten their health. Threats include urban and industrial effluents, runoff from forestry and agriculture, oil and gas shipping and exploration, plastics and debris, and climate change. Understanding the nature and extent of these threats is a basis for policies and practices to protect ocean health for future generations.