Assessing the health of ecosystems has become a focal point among researchers worldwide. Recently, the European Water Framework Directive intensified the development of approaches to assess ecosystems' ecological quality. The Benthic Assessment Tool (BAT) is a multimetric approach to evaluate condition of subtidal soft bottom macroinvertebrates of coastal and transitional waters. The effects of anthropogenic disturbances on benthic macroinvertebrate communities, from 1990 to 2006, allowed testing BAT performance in Mondego estuary (Portugal). The method was able to detect decrease on ecological quality, induced essentially by eutrophication and physical disturbances, and follow communities' subsequent recovery. It evidenced, nevertheless, some limitations associated with the unstable nature of estuaries. The ecological classification of key species in the community and the balance expected between ecological groups of estuarine communities had great influence in the final ecological assessment. Shortcomings of the method were discussed in the light of its suitability for assessing transitional waters' condition.