The Forth Estuary has a rich history as a successful and thriving commercial river.  Historically it would have been busy with fishing vessels, and the transportation of coal and lime down the river.  Today there are still a few boats fishing for crabs, lobsters and prawns but the main commercial traffic comes from tankers visiting the various ports on the Forth. These tankers export oil from Hound Point, LPG & ethylene from Braefoot Bay Terminal, and various chemical and oil derivatives that go to and from Grangemouth Refinery.

Rosyth Dockyard also plays an important part in the commercial traffic of the Forth Estuary with frequent cargo ships delivering to its docks, and the activity involved in building the new Royal Navy Aircraft Carriers. In addition to the Dockyard, there are other ports that are busy with commercial activity; such as, Inverkeithing, Leith and Methil.

As well as the commercial ships that come in to the Forth, it is an extremely popular river for recreational use. Whilst in the past locals and visitors may have enjoyed the river on one of the coastal steamers or the Forth ferry, today the river is popular with smaller boats such as yachts and kayaks. Cruise ships are also a common sight in the Forth Estuary as they come in to port at Leith or Newhaven, or anchor at Hound Point.