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Water bodies in the urban landscape are omnipresent, with many being small, lentic waters such as ponds and lakes. Because of high anthropogenic forcing, these systems have poor water quality, with large consequences for the provisioning of ecosystem services. Understanding of the main pressures on urban water quality is key to successful management. We identify six pressures that we hypothesize to have strong links to anthropogenic forcing including: eutrophication, aquatic invasive species, altered hydrology, altered habitat structure, climate change, and micropollutants. We discuss how these pressures may affect water quality and ecological functioning of urban waters. We describe how these pressures may interact, posing challengers for water management. We identify steps that need to be taken towards sustainable restoration, recognizing the challenges that potentially interacting pressures pose to water managers.