Marine, freshwater and terrestrial ecosystems face increasing anthropogenic threats that are exacerbated by the ecological connectivity between realms; integrated land-sea management (ILSM) is a framework that can help address this connectivity. However, gaps in our knowledge regarding ILSM remain. This study reviewed 108 relevant studies to understand how ILSM is being utilized. Summarized are: (1) characteristics of integrated land-sea programs; (2) recommendations made from the literature for program planning, implementation and management; (3) how applied programs have been planned, implemented and managed; and (4) recommendations for undertaking ILSM. It was found that applied programs did not often adhere to the strategies recommended by theoretical papers. Applied programs were less likely than theoretical papers to specifically name the land-sea connection, over 50% did not apply a framework or governance approach, many did not include key stakeholders, and over 80% listed at least one conflict or hurdle that decreased program success. This study highlighted the difficulties of undertaking ILSM given the high number of stakeholders, government agencies and experts involved. Based on the findings, recommendations for future ILSM programs are provided.