A variety of approaches have been devised to formulate national and regional sediment quality guidelines (SQGs) by various national and provincial agencies during the past 20 years. Most of these approaches are developed in North America, based directly or indirectly on the biological effects of sediment-associated contaminants, and focus on the protection of benthic organisms. These approaches can be categorized as the theoretically based approaches that attempt to account for the dynamic equilibrium of the contaminant exiting between sediment solids and interstitial water through equilibrium partitioning (EqP), and approaches based on sediment toxicity test, in situ biological effects survey and biological effect frequency. Each approach has certain advantages and limitations. The major problems with current approaches are the difficulties to establish causal relation and identify the factors and their ability mediating the bioavailability of sediment-associated contaminants. This review indicates that no single approach is likely to support deriving sediment quality guidelines (SQGs) under all circumstances. Standard chemical and biological testing methods should be established to improve the reliability of relevant data, and the integration of different approaches is also important in deriving sediment quality guidelines (SQGs).