Humans may be exposed to microbial pathogens at recreational beaches via environmental sources, such as water, sand, and aerosols. Although infectious disease risk from exposure to waterborne pathogens has been an active area of research for decades, sand is a relatively unexplored reservoir of pathogens and fecal indicator bacteria (FIB). Beach sand and water habitats provide unique advantages and challenges to pathogen introduction, growth, and persistence, as well as continuous exchange between habitats. Models of FIB and pathogen fate and transport in sandy beach habitats can help predict the risk of infectious disease from recreational water use, but filling knowledge gaps such as decay rates and potential for microbial growth in beach habitats is necessary for accurate modeling. Climatic variability, whether natural or anthropogenically-induced, adds complexity to predictive modeling, but may increase human exposure to waterborne pathogens via extreme weather events, warming of water bodies and sea level rise in many regions. The popularity of human recreational beach activities, combined with predicted climate change scenarios, could amplify the risk of human exposure to pathogens and related illnesses. Other global change trends such as increased population growth and urbanization are expected to exacerbate contamination events and the predicted impacts of increasing levels of waterborne pathogens on human health. Such changes will alter microbial population dynamics in beach habitats, and will consequently affect the assumptions and relationships used in population models and quantitative microbial risk assessment (QMRA). Here, we discuss the literature on microbial population and transport dynamics in sand-water continuum habitats at beaches, how these dynamics can be modeled, and how climate change and other anthropogenic influences (e.g., land use, urbanization) should be considered when using and developing more holistic, beachshed-based models.