Substantial increases in non-native aquatic vegetation have occurred in the upper San Francisco Estuary over the last 2 decades, largely from the explosive growth of a few submerged and floating aquatic plant species. Some of these species act as ecosystem engineers by creating conditions that favor their further growth and expansion as well as by modifying habitat for other organisms. Over the last decade, numerous studies have investigated patterns of expansion and turn-over of aquatic vegetation species; effects of vegetation on ecosystem health, water quality, and habitat; and effects of particular species or communities on physical processes such as carbon and sediment dynamics. Taking a synthetic approach to evaluate what has been learned over the last few years has shed light on just how significant aquatic plant species and communities are to ecosystems in the Sacramento-San Joaquin Delta. Aquatic vegetation affects every aspect of the physical and biotic environment, acting as ecosystem engineers on the landscape. Furthermore, their effects are constantly changing across space and time, leaving many unanswered questions about the full effects of aquatic vegetation on Delta ecosystems and what future effects may result, as species shift in distribution and new species are introduced. Remaining knowledge gaps underlie our understanding of aquatic macrophyte effects on Delta ecosystems, including their roles and relationships with respect to nutrients and nutrient cycling, evapotranspiration and water budgets, carbon and sediment, and emerging effects on fish species and their habitats. This paper explores our current understanding of submerged and floating aquatic vegetation (SAV and FAV) ecology with respect to major aquatic plant communities, observed patterns of change, interactions between aquatic vegetation and the physical environment, and how these factors affect ecosystem services and disservices within the upper San Francisco Estuary.