Onsite wastewater treatment systems (OWTS) are a major source of excess nutrients and co-pollutants in watersheds across the United States. In Barnstable County (Cape Cod), Massachusetts, effluent from septic systems and cesspools contributes approximately 80% of the controllable reactive nitrogen (N) load to numerous impaired estuaries and degrades water quality in the region's sole source aquifer, streams and ponds. In unsewered areas, wastewater N loads could be reduced substantially by Innovative/Alternative (I/A) septic systems designed for enhanced removal. Use, however, has been partly limited by the availability of high performing, cost effective options, while conventional septic systems continue to be installed in watersheds with well documented N impairments. This paper describes the strategic replacement of residential OWTS with two I/A models that incorporate woodchip bioreactors to enhance N removal. Systems were installed at 14 neighboring homes in Barnstable, MA, and monitored for field performance. Influent and effluent were sampled monthly and analyzed for N and phosphorus (P), among other water quality indicators. Flow to each system was continuously metered to estimate nutrient loads. Results from the first 25 months of monitoring for 13 systems with at least a full year of data are presented in terms of 1) reductions in nutrient concentrations and mass loads and 2) reliability of the systems for meeting a performance goal of total N (TN) < 10 mg/L. Discussion supports consideration of where and how these technologies may be successfully used to manage excess N in sensitive watersheds.