Declining natural resources have led to a cultural renaissance across the Pacific that seeks to revive customary ridge-to-reef management approaches to protect freshwater and restore abundant coral reef fisheries. Effective ridge-to-reef management requires improved understanding of land-sea linkages and decision-support tools to simultaneously evaluate the effects of terrestrial and marine drivers on coral reefs, mediated by anthropogenic activities. Although a few applications have linked the effects of land cover to coral reefs, these are too coarse in resolution to inform watershed-scale management for Pacific Islands. To address this gap, we developed a novel linked land-sea modeling framework based on local data, which coupled groundwater and coral reef models at fine spatial resolution, to determine the effects of terrestrial drivers (groundwater and nutrients), mediated by human activities (land cover/use), and marine drivers (waves, geography, and habitat) on coral reefs. We applied this framework in two ‘ridge-to-reef’ systems (Hā‘ena and Ka‘ūpūlehu) subject to different natural disturbance regimes, located in the Hawaiian Archipelago.