Land cover patterns were evaluated in 29 estuarine watersheds of South Carolina to determine relationships between urban/suburban development and estuarine habitat quality. Principal components analysis and Pearson product moment correlation analyses were used to examine the relationships between ten land cover categories and selected measures of nutrient or bacterial enrichment in the water column and contaminant enrichment in sediments. These analyses indicated strong relationships between land cover categories representing upland development and a composite measure of 24 inorganic and organic contaminants using the Effect Range Median-Quotient (ERM-Q). Similar relationships also were observed for the summed concentrations of polycyclic aromatic hydrocarbons (PAHs), polychlorinated biphenyls (PCBs), pesticides, and metals. Data obtained from tidal creeks generally showed stronger correlations between urban/suburban land use and pesticides and metals compared to data obtained from larger open water habitats. Correlations between PAH concentrations and the urban/suburban land cover categories were similar between creek and open water habitats. PCB concentrations generally showed very little relationship to any of the land cover categories. Measures of nutrient enrichment, which included total Kjeldahl nitrogen (TKN), nitrate-nitrite, phosphorus, chlorophyll-a, and total organic carbon, were generally not significantly correlated with any land cover categories, whereas fecal coliform bacteria were significantly and positively correlated with the urban/suburban land cover categories and negatively correlated with the non-urban land cover categories. Fecal coliform correlations were stronger using data from the open water sites than from the tidal creek sites. Both ERM-Q and fecal coliform concentrations were much greater and more pervasive in watersheds with relatively high (>50%) urban/suburban cover compared to watersheds with low (<30%) urban/suburban cover. These analyses support the hypotheses that estuarine habitat quality reflects upland development patterns at large spatial scales, and that upland urbanization can result in increased risk of biological degradation and reduced safe human use of South Carolina's coastal resources.