Aquatic ecosystems are essential for ecosystem services, including the direct ecological, social and economic benefits they provide (e.g. energy, fisheries, drinking water), the regulation they perform (e.g. hydrologic and nutrient regulation, waste processing), and the cultural benefits they deliver (e.g., recreational paddling, swimming, fishing). Managing multiple aquatic ecosystem services and their interactions affected by mounting pressures from land-use and climate change is an urgent challenge, yet synthesis of frameworks for assessing the delivery of aquatic ecosystem services across different spatial and temporal scales is lacking. As aquatic ecosystem services are spatially and temporally dynamic, it is key to account for the uncertainties related to ongoing and future climate and land-use change. Such dynamics among multiple ecosystem services have been largely ignored until recently. Furthermore, aquatic ecosystem services can interact and be affected by terrestrial ecosystems. Hence it is important to integrate knowledge and develop management planning at the interface of terrestrial and aquatic systems (e.g. forest-stream, lake-stream-riparian zones, wetland-land) that may amplify the risk of shortage of aquatic ecosystem services in some regions. Given the synergy among natural fluctuations, natural and man-driven disturbances, and climate change, novel analytical methods are needed to generate early detection of changes in these systems that might impair the delivery of aquatic ecosystem services. The development of conceptual frameworks and analytical tools need to be built upon quantitative indicators of ecosystem health and functions provided by these ecosystems at multiple spatial scales. As each aquatic ecosystem service is subjected to various degree of demands yet have their own spatio-temporal abundance and fluctuation, management at the watershed level could mitigate such local variations enhancing the resilience of aquatic ecosystem services. To better management the interactions and trade-offs among aquatic ecosystem services, it is important to first determine their individual scope and combined interplay. The aim of this symposium is to present (1) the vast range of aquatic ecosystem services and the current state of the science for their quantification, (2) quantitative indicators and analytical tools to integrate the inherent variability of services from multiple scales, and (3) how this integration can be used to build management strategies to ensure ecosystem health.