Often perceived as environmentally benign, 'green' renewable energy technologies have ecological costs that are often overlooked, especially those occurring below the waterline. After briefly discussing the impacts of hydropower on freshwater and marine organisms, we focus this review on the impacts of marine renewable energy devices (MREDs) on underwater marine organisms, particularly offshore wind farms and marine energy converters (e.g., tidal turbines). We consider both cumulative impacts and synergistic interactions with other anthropogenic pressures, using offshore wind farms and the Taiwanese white dolphin (Sousa chinensis taiwanensis) as an example. While MREDs undoubtedly can help mitigate climate change, variability in the sensitivity of different species and ecosystems means that rigorous case-by-case assessments are needed to fully comprehend the consequences of MRED use.