Anthropogenic stressors, such as marine pollution, vessel activities, and climate change, are driving a decline in the health of coastal dolphins globally. Despite this, in Southeast Queensland, limited literature on dolphin health exists. Here, we conducted novel health assessments by investigating the origin and prevalence of epidermal lesions among four coastal dolphin species (Indo-Pacific bottlenose dolphins (Tursiops aduncus), Australian humpback dolphins (Sousa sahulensis), common dolphins (Delphinus delphis) and common bottlenose dolphins (Tursiops truncatus)). We documented epidermal marks, including lesions resulting from fungus, bacteria, virus, boat strikes, and fishing gear entanglement and assessed the biological, environmental, and anthropogenic drivers of occurrence. We identified nine lesion types among species, with the highest prevalence linked to disease-related origins. Species, age, and regional differences in lesion prevalence were evident (p<0.05). Additionally, decreased water temperature, increased rainfall, and decreased proximity to river mouths resulted in greater lesion occurrence (p<0.05). These findings establish baseline health criteria for coastal dolphins in the region and provide vital insights to inform development of effective conservation strategies. As stressors on marine ecosystems continue to intensify, understanding their impacts on dolphin health are crucial for ensuring long-term survival of these socially, economically, and ecologically important species within a rapidly changing environment.