This chapter focuses on the temporal dynamics, spatial extent and cumulative impacts of current and future drivers of change on Great Barrier Reef water quality, and subsequent impacts on marine ecosystems in the Great Barrier Reef Marine Park. These include the acute influences of large flood events driven by extreme weather, salinity stress, tropical cyclones, thermal stress, crown-of-thorns starfish outbreaks and other anthropogenic drivers such as coastal development activities. To date, impacts on the Great Barrier Reef from these drivers have been documented but the potential for additive and synergistic effects will be more severe than indicated from studies of individual stressors (Veron et al., 2009).