Anthropogenic environmental changes can serve as drivers for evolutionary responses in wild populations. To predict the long-term impact of anthropogenic changes on populations, it is crucial to understand the genetic effects caused by these disturbances. The Baltic Sea is considered to be one of the world’s most contaminated seas, and the increase of anthropogenic chemical pollution is a major threat to its ecosystems. This thesis assesses the impact of harbors and sewage treatment plants on physiological traits and genetic structure of resident populations of blue mussels at replicated sites in the Baltic Sea. The initial evaluation of the overall genetic pattern in blue mussel populations in the Swedish West Coast, the Baltic Proper and the Bothnian Sea found genetic differentiation between the three water basins and a low genetic differentiation within each basin, especially within the Baltic Proper. Despite the low genetic differentiation among blue mussels within the Baltic Proper, a parallel genetic differentiation associated with sewage treatment plant effluents was found in this basin. This included genomic regions with a high degree of differentiation between reference sites and sites affected by sewage plants effluent. This genetic differentiation is suggested to be due to post-dispersal selection acting in each generation. In contrast, no parallel genetic differentiation was associated with harbors. We identified five genomic regions in blue mussels, showing strong signs of selection, shared among three out of four replicated reference sites and sites affected by sewage effluents in the Baltic Proper i.e. Askö, Tvärminne and Karlskrona. An initial characterization of these genomic regions revealed functions related to immune and endocrine responses, oxidative stress and shell formation. Our results indicate that selection caused by sewage effluents involves multiple loci. The same genomic regions are found across different locations in the Baltic Proper but there are also unique genomic regions at each location. No genotoxic or histopathological effects were found among blue mussels from sewage effluent-affected areas but a higher frequency of histological abnormalities in the digestive gland were observed in mussels from harbors.