Existing research on nutrients (nitrogen and phosphorus) in the Upper Mississippi River (UMR) can be organized into the following categories: (1) Long-term changes in nutrient concentrations and export, and their causes; (2) Nutrient cycling within the river; (3) Spatial and temporal patterns of river nutrient concentrations; (4) Effects of elevated nutrient concentrations on the river; and (5) Actions to reduce river nutrient concentrations and flux. Nutrient concentration and flux in the Mississippi River have increased substantially over the last century because of changes in land use, climate, hydrology, and river management and engineering. As in other large floodplain rivers, rates of processes that cycle nitrogen and phosphorus in the UMR exhibit pronounced spatial and temporal heterogeneity because of the complex morphology of the river. This spatial variability in nutrient processing creates clear spatial patterns in nutrient concentrations. For example, nitrate concentrations generally are much lower in off-channel areas than in the main channel. The specifics of in-river nutrient cycling and the effects of high rates of nutrient input on UMR have been less studied than the factors affecting nutrient input to the river and transport to the Gulf of Mexico, and important questions concerning nutrient cycling in the UMR remain. Eutrophication and resulting changes in river productivity have only recently been investigated the UMR. These recent studies indicate that the high nutrient concentrations in the river may affect community composition of aquatic vegetation (e.g., the abundance of filamentous algae and duckweeds), dissolved oxygen concentrations in off-channel areas, and the abundance of cyanobacteria. Actions to reduce nutrient input to the river include changes in land-use practices, wetland restoration, and hydrological modifications to the river. Evidence suggests that most of the above methods can contribute to reducing nutrient concentration in, and transport by, the UMR, but the impacts of mitigation efforts will likely be only slowly realized.