Coral reefs the world over are being threatened by anthropogenic factors, one of the most significant being nutrient enrichment of the coastal waters. The Coral Coast region, in south-western Viti Levu, Fiji, has undergone very rapid development since the 1970s. Observations by local communities and the few sporadic studies conducted in the area have shown progressive degradation of the fringing reefs and deterioration of the water quality. In the present study, while water column nutrient concentrations showed high variability, averages over a long period of monitoring showed clear associations between anthropogenic effects and water quality. Nutrient concentrations were highly variable, and showed little association with season, but were strongly linked to rainfall. The results also indicated the clear influence of pulse (storm runoff related) events on the nutrient and fecal coliform concentrations in the water column. Control sites located furthest from human settlements and development generally recorded lower nutrient and coliform concentrations than impacted sites. The importance of creeks as major sources of nutrient and fecal coliform to coastal waters was clearly evident, and this highlighted the need to properly manage catchment activities. Recommendations are proposed for better management of nutrient sources on land for the protection of the water quality, and therefore promote healthier coral reef systems.