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Southern states face many challenges in developing TMDLs including litigation, vocal public concerns, and arduous efforts at collecting data and assessing waterbody conditions. These states are also adopting a variety of voluntary, incentive-based, and regulatory measures to reduce nonpoint pollution and implement credible, economical, publicly acceptable, and technically feasible TMDL programs. Our objectives were to assess how southern sates are identifying impaired waterbodies, developing TMDL plans, and implementing remediation strategies. We reviewed primary literature on state activities and assessed them against legal requirements. Key findings include the need for more specific guidelines states can adapt to their needs and a national clearinghouse of innovative state efforts all states can draw upon.