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There is a perception that anthropogenically-driven changes in nutrient supply to coastal waters influences the abundance, frequency and toxicity of harmful algal blooms (HABs) through a change in the form or ratio of nutrient that limits phytoplankton growth. If nutrient concentrations are not limiting for growth, then ratios do not influence floristic composition. At non-limiting concentrations, evidence that alteration of nitrogen: phosphorus (N:P) ratios has stimulated HABs is limited, and primarily based on hypothesised relationships in relatively few locations (in particular: Tolo Harbour Hong Kong and Dutch Coastal Waters). In all cases, an unequivocal causal link between an increase in HABs (frequency, magnitude or duration) and change in N or P as the limiting nutrient is difficult to establish. The silicon (Si) limitation hypothesis is generally supported by experimental evidence and field data on the nuisance flagellate Phaeocystis. We found little evidence that high N:Si ratios preferentially promote harmful dinoflagellates over benign species. Laboratory studies demonstrate that nutrient ratios can influence toxin production, but genus and species specific differences and environmental control make extrapolation of these data to the field difficult. Studies of the role of dissolved and particulate organic nutrients in the growth of HAB species, while limited, demonstrate the potential for organic nutrients (especially organic N) to support the growth of a range of HAB species. There is a clear need for better understanding of the role of mixotrophy in the formation of HABs and for studies of HAB and non-HAB species in competition for environmentally realistic concentrations of organic nutrients.