In the Tred Avon River, an important tributary of the Choptank River, we assessed the impacts of land use on the health of the aquatic ecosystem in a 3-year field study (2015-2017). In our analysis of information collected during the study, we looked for parallels between the conditions found and potential influencing factors such as land-use or other patterns. Also in this study, a suite of models was applied to determine the current nutrient-related water quality conditions and potential need for additional nutrient management measures, and to estimate the ecosystem service of nitrogen removal being provided through oyster filtration at restored oyster reefs and aquaculture sites. The intent of this assessment was to guide community planners, local governments, industry, and other decision makers faced with increasing demands to make changes to the landscape.