The use of combined approaches to coastal adaptation in lieu of a single strategy, such as sea-wall construction, allows for better preparation for a highly uncertain and dynamic coastal environment. Although general principles such as mainstreaming and no- or low-regret options exist to guide coastal adaptation and provide the framework in which combined approaches operate, few have examined the interactions, synergistic effects and benefits of combined approaches to adaptation. This Perspective provides three examples of ecological engineering-marshes, mangroves and oyster reefs-and illustrates how the combination of ecology and engineering works.