Best management practices (BMPs) for reducing agricultural non-point source pollution are widely available. However, agriculture remains a major global contributor to degradation of waters because farmers often do not adopt BMPs. To improve water quality, it is necessary to understand the factors that influence BMP adoption by farmers. We review the findings of BMP adoption studies from both developed and developing countries, published after (or otherwise not included in) two major literature reviews from 2007 and 2008. We summarize the study locations, scales, and BMPs studied; the analytical methods used; the factors evaluated; and the directionality of each factor’s influence on BMP adoption. We then present a conceptual framework for BMP adoption decisions that emphasizes the importance of scale, the tailoring or targeting of information and incentives, and the importance of expected farm profits. We suggest that future research directions should focus on study scale, on measuring and modeling of adoption as a continuous process, and on incorporation of social norms and uncertainty into decision-making. More research is needed on uses of social media and market recognition approaches (such as certificate schemes and consumer labeling) to influence BMP adoption.