Governance across the land-sea interface is an emerging challenge. The propensity for, and intensity of social-ecological interactions across this interface (e.g., eutrophication, sedimentation) are being exacerbated by cross-system threats (e.g., climate change). We draw on a systematic review of 151 peer-reviewed papers on governance and land-sea connections to (1) outline the current state of the literature, (2) examine the predominance of different approaches to address land-sea interactions, (3) characterize how governance is conceptualized within these approaches, (4) investigate governance challenges, and (5) provide insights into effective governance. The review finds that the number of relevant papers published per year has generally been increasing, and most of these papers are found in interdisciplinary journals. Ecosystem-based management is the most predominant approach found in the literature as a means to address land-sea interactions. Papers referring to ecosystem-based management are more likely than those referring to alternative management approaches (e.g., integrated management) to highlight science-policy integration and the need to account for interactions between ecosystem components as elements of effective governance. The main governance challenges include determining boundaries, addressing cross-scale effects, and accessing knowledge. However, few empirical studies of governance across the land-sea interface have been completed. A richer conceptual framework of governance is required to improve our ability to navigate the rapid social and environmental change occurring across the land-sea interface.