This contribution presents a new view of the global carbon cycle which accounts for the land-to-ocean transport of carbon through inland waters, estuaries, tidal wetlands and the coastal ocean —the ‘land-to-ocean aquatic continuum’ (LOAC). We briefly review how modern-day observations and models support this new view and help constrain the spatiotemporal variability in lateral and vertical carbon fluxes, in particular air-water CO₂ exchanges. We then highlight how physical, biogeochemical and ecological processes from land-to-ocean have been perturbed by human interventions, including atmospheric composition change, climate change and land-use change. The extent to which these anthropogenic perturbations have altered regional and global CO₂ budgets and trends along the LOAC are also presented and the knowledge gaps that are key to reduce uncertainties in future assessments of LOAC fluxes are identified. Finally, broader implications regarding the quantification of the terrestrial and open ocean sinks of anthropogenic carbon are briefly discussed.