Biomarkers are applied worldwide in marine environmental assessment due to their "early warning" function to chemical pollutants. Several integrative index approaches such as multi-marker pollution index (MPI), integrated biomarker response (IBR), bioeffect assessment index (BAI), biomarker response index (BRI), and health assessment index (HIS), have been developed based on biomarkers. By transforming the complex alterations of biomarkers into a single class or value, these approaches have been so far the useful tools for assessing the environmental quality. This review summarized the establishment of evaluation indicator system, the calculation of integrative index, the grading of pollution status, and the practical applications of each approach, and discussed the existing problems in marine environmental assessment based on biomarker index. Some improving suggestions were also proposed.