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Organic pollution has been on the rise in the Danube over the last century, as human activities have resulted in increasing loads of wastewater rich in organic matter. The most serious organic pollution problems occur in tributaries that regularly receive untreated or inadequately treated wastewater from industrial plants and municipalities. Thanks to the significant improvement of wastewater infrastructure and services in the Danube countries, the basin-wide organic emissions reduced by 60% since the mid 2000s.

The floodplains and wetlands of the Danube basin are uniquely valuable ecosystems in global terms, although few areas are still in their natural or near-natural state.

Since the 16th century, people have been changing the natural course of the rivers in the Danube River Basin, mainly for flood defence, hydropower generation and navigation. All these changes affect the ecological quality of the rivers. Changes in the depth or width of a river typically reduce flow rates, interrupting natural sediment transportation as well as the migration routes of animals.