Pavement sealants are frequently applied to parking lots and driveways to improve their appearance and protect the integrity of the underlying asphalt. We performed a comprehensive literature review to summarize the potential impacts of refined coal-tar-based sealant (RCTS) runoff to aquatic organisms and to evaluate the strengths and weaknesses of the lines of evidence presented in the literature. The studies reviewed included both laboratory and field exposures, with and without exposure to ultraviolet light, and measured effects on multiple endpoints associated with bacteria, benthic macroinvertebrates, and fish. Several studies demonstrated that constituents in RCTS runoff can affect survival, growth, behavior, development, and molecular responses of aquatic organisms under controlled laboratory settings. However, translating effects observed in the laboratory to field settings, where runoff is diluted and constituents interact with particulate and dissolved stream constituents (e.g., organic matter), has proven difficult. In this review, we identify the strengths and weaknesses of the existing literature and provide recommendations for study designs and methods to fill the most critical data gaps in understanding the risk of this material to aquatic organisms. Our review highlights the need for environmentally relevant study designs that demonstrate cause-effect relationships under field conditions. This article is protected by copyright. All rights reserved.