Karst environments are characterized by distinctive landforms related to dissolution and a dominant subsurface drainage. The direct connection between the surface and the underlying high permeability aquifers makes karst aquifers extremely vulnerable to pollution. A high percentage of the world population depends on these water resources. Moreover, karst terrains, frequently underlain by cavernous carbonate and/or evaporite rocks, may be affected by severe ground instability problems. Impacts and hazards associatedwith karst are rapidly increasing as development expands upon these areas without proper planning taking into account the peculiarities of these environments. This has led to an escalation of karst-related environmental and engineering problems such as sinkholes, floods involving highly transmissive aquifers, and landslides developed on rocks weakened by karstification. The environmental fragility of karst settings, togetherwith their endemic hazardous processes, have received an increasing attention from the scientific community in the last decades. Concurrently, the interest of planners and decision-makers on a safe and sustainable management of karst lands is also growing. This work reviews the main natural and human-induced hazards characteristic of karst environments, with specific focus on sinkholes, floods and slope movements, and summarizes the main outcomes reached by karst scientists regarding the assessment of environmental impacts and their mitigation.