Turbid water or suspended sediment is associated with negative effects on aquatic organisms; fish, aquatic invertebrate, and periphyton. Effects of turbid water on fish differ depending on their developmental stage and a level of turbidity. Low turbid water may cause feeding and predation rates, reaction distance, and avoidance in fish, and it could make fish to die under high turbidity and long period. Therefore, it is very important to find out how turbid water or suspended sediment can affect fish in domestic watersheds. The objectives of this study were 1) to introduce international case studies and their standards to deal with suspended sediment, 2) to determine acute toxicity in 4 major freshwater fishes, and 3) to determine in relation to adverse effect of macroinvertebrates and fish. Impacts of turbid water on fish can be categorized into direct and indirect effects, and some factors such as duration and frequency of exposure, toxicity, temperature, life stage of fish, size of particle, time of occurrence, availability of and access to refugia, etc, play important role to decide magnitude of effect. A review of turbidity standard in USA, Canada, and Europe indicated that each standard varied with natural condition, and Alaska allowed liberal increase of turbidity over natural conditions in streams. Even though acute toxicity with four different species did not show any fatal effect, it should be considered to conduct a chronic test (long-term) for more detailed assessment. Compared to the control, dominance index of macroinvertebrates was greater in the turbid site, whereas biotic index, species diversity index, species richness index, and ecological score were smaller in the turbid site. According to histopathological analysis with gills of macroinvertebrate and fishes, morphological and physiological modification of gills due to suspended sediments can cause disturbance of respiration, excretion and secretion. In conclusion, in order to maintain good and healthy aquatic ecosystem, it is the best to minimize or prevent impact by occurrence of turbid water in stream and reservoir. We must make every effort to maintain and manage healthy aquatic ecosystem with additional investigation using various assessment tools and periodic biomonitoring of fish.