Surface water quality management requires foresighted decision making regarding long-term investments. It should consider multiple objectives (e.g. related to different pollutants and costs), integrate multiple sources of pollution (point and diffuse sources), and external conditions that change over time (climate, population and land-use changes). Multi-attribute value theory can support such decisions, especially the development of an assessment method. Integrated surface water quality assessment methods including micropollutants are currently lacking or in development in many countries. Important steps for the development of such an immission oriented and integrated surface water quality assessment method are discussed in this paper and exemplified for organic micropollutants. The proposed assessment method goes beyond simple pass-fail criteria for single substances. It provides a continuous assessment on a scale from zero to one based on five color-coded water quality classes and suggestions for the visualization of assessment results. It takes into account the toxicity of the micropollutants and their mixture to aquatic organisms by comparing measured concentrations to environmental quality standards (EQS). The focus of this paper is on aggregation over multiple substances and time. Advantages and disadvantages of different aggregation methods are discussed as well as their implications for practice. The consequences of different aggregation methods are illustrated with didactical examples and by an application of the proposed water quality assessment method to pesticide monitoring data from Switzerland. Recommendations are provided that account for the purpose of the assessment. Furthermore, the paper illustrates how the proposed method can facilitate dealing with uncertainty and a transparent communication of monitoring results to support water quality management decisions.