If sustainable development of Canadian waters is to be achieved, a realistic and manageable framework is required for assessing cumulative effects. The objective of this paper is to describe an approach for aquatic cumulative effects assessment that was developed under the Northern Rivers Ecosystem Initiative. The approach is based on a review of existing monitoring practices in Canada and the presence of existing thresholds for aquatic ecosystem health assessments. It suggests that a sustainable framework is possible for cumulative effects assessment of Canadian waters that would result in integration of national indicators of aquatic health, integration of national initiatives (e.g., water quality index, environmental effects monitoring), and provide an avenue where long-term monitoring programs could be integrated with baseline and follow-up monitoring conducted under the environmental assessment process.