Sheltered coastal areas, such as those along bays and estuaries, experience land loss from erosion and sea level rise much like ocean beaches. Owners of property along sheltered coasts often reinforce their shoreline with bulkheads and other structures to prevent erosion; however, this construction alters the coastal ecosystem, causing changes that threaten landscapes, public access, recreational opportunities, natural habitats, and fish populations. At the request of the U.S. Environmental Protection Agency, the U.S. Army Corps of Engineers, and the Cooperative Institute for Coastal and Estuarine Environmental Technology, this report examines the impacts of shoreline management on sheltered coasts and calls for a regional management approach that considers the environmental impacts that could accumulate if hard structures are permitted on a site by site basis. In addition, this report recommends changing the current permitting system to remove the default preference for bulkheads and similar structures and to allow more flexibility to encourage use of more ecologically beneficial erosion-control methods, such as planting of marshes.