To support the development of the Reef 2050 Water Quality Improvement Plan 2017-2022, a multidisciplinary group of scientists, with oversight from the Reef Independent Science Panel, was established to review and synthesise the significant advances in scientific knowledge of water quality issues in the Great Barrier Reef to arrive at a consensus on the current understanding of the system. For the 2017 Scientific Consensus Statement, the information and findings in these assessments and in other scientific publications were reviewed and synthesised in four supporting chapters. This fifth and final chapter provides a synthesis of the key findings of these four chapters and, based on this evidence, makes recommendations for future management of water quality in the Great Barrier Reef. The overarching consensus is that: Key Great Barrier Reef ecosystems continue to be in poor condition. This is largely due to the collective impact of land run-off associated with past and ongoing catchment development, coastal development activities, extreme weather events and climate change impacts such as the 2016 and 2017 coral bleaching events. Current initiatives will not meet the water quality targets. To accelerate the change in on-ground management, improvements to governance, program design, delivery and evaluation systems are urgently needed. This will require greater incorporation of social and economic factors, better targeting and prioritisation, exploration of alternative management options and increased support and resources.