Land and ocean ecosystems are strongly connected and mutually interactive. As climate changes and other anthropogenic stressors intensify, the complex pathways that link these systems will strengthen or weaken in ways that are currently beyond reliable prediction. In this review we offer a framework of land–ocean couplings and their role in shaping marine ecosystems in coastal temperate rainforest (CTR) ecoregions, where high freshwater and materials flux result in particularly strong land–ocean connections. Using the largest contiguous expanse of CTR on Earth—the Northeast Pacific CTR (NPCTR)—as a case study, we integrate current understanding of the spatial and temporal scales of interacting processes across the land–ocean continuum, and examine how these processes structure and are defining features of marine ecosystems from nearshore to offshore domains. We look ahead to the potential effects of climate and other anthropogenic changes on the coupled land–ocean meta-ecosystem. Finally, we review key data gaps and provide research recommendations for an integrated, transdisciplinary approach with the intent to guide future evaluations of and management recommendations for ongoing impacts to marine ecosystems of the NPCTR and other CTRs globally. In the light of extreme events including heatwaves, fire, and flooding, which are occurring almost annually, this integrative agenda is not only necessary but urgent.