Major climate and ecological changes affect the world's oceans leading to a number of responses including increasing water temperatures, changing weather patterns, shrinking ice-sheets, temperature-driven shifts in marine species ranges, biodiversity loss and bleaching of coral reefs. In addition, ocean pH is falling, a process known as ocean acidification (OA). The root cause of OA lies in human policies and behaviours driving society's dependence on fossil fuels, resulting in elevated CO2 concentrations in the atmosphere. In this review, we detail the state of knowledge of the causes of, and potential responses to, OA with particular focus on Swedish coastal seas. We also discuss present knowledge gaps and implementation needs.