This chapter focuses on the current situation of aquaculture development in the North Sea region in the light of world-wide decline of wild fish stocks and increasing consumer demand for seafood. With 1.4 Mill. metric tons of annual production the culture of fish, especially salmon and trout, is the most commonly intensively employed aquaculture sector within the North Sea region. This has resulted in several environmental problems, such as eutrophication of the adjacent water column of the aquaculture facility due to food pellets and faeces, as well as the spread of diseases and parasites. The major shellfish species, which is extensively cultured in many countries along the North Sea, is the blue mussel, followed by the pacific oyster. Several shellfish culture techniques have emerged, which are described and discussed in respect to impacts on the environment as well as their future prospective. The chapter closes with a call for integrative action among the North Sea region states for the further promotion of ecological and socio-economic sound aquaculture development by endorsing the idea of ICZM in order to sustain its economic potential as alternative livelihood for coastal communities.