Urban water quality management is becoming an increasingly complex and widespread problem. The long-term viability of aquatic ecosystems draining urban watersheds can be addressed through both regulatory and nutrient and water management initiatives. This review focuses on U.S. regulatory (federal, state, and local) and management (runoff, atmospheric deposition, and wastewater) impacts on urban water quality, specifically emphasizing programs in Florida. Because of rapid population growth in recent decades, and projected increases in the future, appropriate resource management in Florida is essential. Florida enacted stormwater regulations in 1979, before the U.S. Environmental Protection Agency (USEPA) amended the Clean Water Act (CWA) to regulate stormwater discharges. However, in the United States, more research has been conducted on larger structural best management practices (BMPs) (e.g., wet ponds, detention basins, etc.) compared with smaller onsite alternatives (e.g., green roofs, permeable pavements, etc.). For atmospheric deposition, research is needed to investigate processes contributing to enhanced deposition rates. Wastewater (from septic systems, treatment plants, and landfills) management is especially important in urban watersheds. Failing septic systems, elevated nutrient concentrations in discharged effluent, and landfill leachate can all potentially degrade water quality. Proposed numeric nutrient criteria from the USEPA and innovative technologies such as bioreactor landfills are emergent regulatory and management strategies for improved urban water quality.