As sea surface temperatures rise and the global human population increases, large-scale field observations of marine organism health and water quality are increasingly necessary. We investigated the health of corals from the family Fungiidae using visual observations in relation to water quality and microbial biogeochemistry parameters along 1300 km of the Red Sea coast of Saudi Arabia. At large scales, incidence of lesions caused by unidentified etiology showed consistent signs, increasing significantly from the northern to southern coast and positively correlated to annual mean seawater temperatures. Lesion abundance also increased to a maximum of 96% near the populous city of Jeddah. The presence of lesioned corals in the region surrounding Jeddah was strongly correlated with elevated concentrations of ammonium and changes in microbial communities that are linked to decreased water quality. This study suggests that both high seawater temperatures and nutrient pollution may play an indirect role in the formation of lesions on corals. © 2014 Elsevier Ltd.