Coastal benthic ecosystems may be impacted by numerous human activities, including aquaculture, which continues to expand rapidly. Indeed, today aquaculture worldwide provides more biomass for human consumption than do wild fisheries. This rapid development raises questions about the interactions the practice has with the surrounding environment. In order to design strategies of sustainable ecosystem exploitation and marine spatial planning, a better understanding of coastal ecosystem functioning is needed so that tools to quantify impacts of human activities, including aquaculture, may be developed. To achieve this goal, some possible directions proposed are integrated studies leading to new concepts, model development based on these concepts and comparisons of various ecosystems on a global scale. This review draws on existing literature to (i) briefly summarize the major ecological interactions between off-bottom shellfish aquaculture and the environment, (ii) introduce research on the influence of benthic diversity on ecosystem functioning (BEF relationships) and (iii) propose a holistic approach to conduct aquaculture–environment studies using a BEF approach, highlighting the need for integrated studies that could offer insights and perspectives to guide future research efforts and improve the environmental management of aquaculture.