Ecosystems experiencing pressures are at risk of rapidly transitioning (“tipping”) from one state to another. Identifying and managing these so-called tipping points continue to be a challenge in marine, freshwater, and terrestrial ecosystems, particularly when multiple potentially interacting drivers are present. Knowledge of tipping points, the mechanisms that cause them, and their implications for management practices are evolving, but often in isolation within specific ecological realms. Here, we summarize current knowledge of tipping points in marine, freshwater, and terrestrial realms and provide a multi-realm perspective of the challenges and opportunities for applying this knowledge to ecosystem management. We brought together conservation practitioners and global experts in marine, freshwater, and terrestrial tipping points and identified seven challenges that environmental policymakers and managers contend with including (1) predictability, (2) spatiotemporal scales, (3) interactions, (4) reversibility, (5) socio-ecological context, (6) complexity and heterogeneity, and (7) selecting appropriate action. We highlight opportunities for cross-scalar and cross-realm knowledge production and provide recommendations for enabling the management of tipping points. Although knowledge of tipping points is imperfect, we stress the need to continue working toward incorporating tipping points perspectives in environmental management across all realms.