There is significant commercial and research interest in the application of sea cucumbers as nutrient recyclers and processors of particulate waste in polyculture or integrated multitrophic aquaculture (IMTA) systems. The following article reviews examples of existing IMTA systems operating with sea cucumbers, and details the role and effect of several sea cucumber species in experimental and pilot IMTA systems worldwide. Historical observations and quantification of impacts of sea cucumber deposit-feeding and locomotion are examined, as is the development and testing of concepts for the application of sea cucumbers in sediment remediation and site recovery. The extension of applied IMTA systems is reported, from basic piloting through to economically viable farming systems operating at commercial scales. The near-global recognition of the ecological and economic value of deposit-feeding sea cucumbers in IMTA applications within existing and developing aquaculture industries is discussed. Predictions and recommendations are offered for optimal development of sea cucumber IMTA globally. Future directions within the industry are indicated, and key areas of ecological, biological and commercial concern are highlighted to be kept in mind and addressed in a precautionary manner as the industry develops.