Regime shifts have been observed inmarine ecosystemsaround the globe. These phenomena can result in dramatic changes in the provision of ecosystem services to coastal communities. Accounting for regime shifts in management clearly requires integrative, ecosystem-based management (EBM) approaches. EBMhas emerged as an accepted paradigmfor ocean managementworldwide, yet, despite the rapid and intense development of EBMtheory, implementation has languished, and many implemented or proposed EBM schemes largely ignore the special characteristics of regime shifts. Here, we first explore key aspects of regime shifts that are of critical importance to EBM, and then suggest howregime shifts can be better incorporated into EBMusing the concept of integrated ecosystem assessment (IEA). An IEA uses approaches that determine the likelihood that ecological or socio-economic properties of systems will move beyond or return to acceptable bounds as defined by resource managers and policy makers. We suggest an approach for implementing IEAs for cases of regime shifts where the objectives are either avoiding an undesired state or returning to a desired condition. We discuss the suitability and short-comings of methods summarizing the status of ecosystem components, screening and prioritizing potential risks, and evaluating alternative management strategies. IEAs are evolving as an EBMapproach that can address regime shifts; however, advances in statistical, analytical and simulation modelling are needed before IEAs can robustly inform tactical management in systems characterized by regime shifts.