The environmental impacts of ports have seen increasing attention in recent years, from the academic community, regulatory bodies, and port authorities. The growth of maritime transport has led to the expansion of ports that now need to handle larger vessels—this has a severe impact on local air quality and the marine environment. This article reviews prominent environmental issues that port operations are responsible for and presents the most important regulations, technologies, and initiatives from port associations and authorities that seek to address the issue of pollutant emissions, ballast water treatment, and energy consumption. This article finishes off with suggestions for closer cooperation of regulators and port authorities in developing improved initiatives to reduce the negative effects of port operations.