The Atlantic Coast Pipeline is being built through low-income counties of Eastern North Carolina, and will impact African American and Native American communities disproportionately (The News & Observer). They risk facing serious health issues as a result of toxic pollution from industrial facilities. In a 2016 report, Clean Water for North Carolina found that compressors on gas pipelines emit volatile organic compounds that are associated with health issues such as higher risks of cancer, birth defects and sinus problems. The closer people live to the compressors, the report said, the higher the risk of problems.

According to the National Association for the Advancement of Coloured People (NAACP),  gas and oil companies have in history often taken advantage of communities that have low levels of political power. In these communities, companies may face lower transaction costs associated with getting needed permits, and they have more ability to influence local government in their favour. 

ACP's shareholders claim that the pipeline would bring jobs to the states where it will run through. However, ABR Alliance, an alliance against the ACP of several interest groups, states that the people hired to construct the pipeline would not be local citizens, but would be contracted help from outside the area (Allegheny-Blue Ridge Alliance).  The permanent positions created would be miniscule compared to the jobs permanently lost due to businesses that would be disrupted, particularly in the tourism industry. 

The ACP would be disastrous for the environment in one of the United States' most important ecosystems. The safety of water supplies for the nearby communities would be threatened. The possibility of long term erosion of the steep mountain terrain through which the routes would pass would increase. Also, safety risks because of the proven instability of the terrain the routes will pass through as well as the risks of pipeline failure would occur. Furthermore, because of the felling of a lot of trees, many protected and unique species of plants and animals would lose their habitat. Moreover, the demolishing of the land would affect agricultural land (Allegheny-Blue Ridge Alliance).

Department of Energy study from 2015 claimed that fill-lifecycle greenhouse gas emissions for electricity production from natural gas are less than half those of coal. However Oil Change International have found that this substantially underestimates the impact of methane leakage along the gas supply chain, and that when this is fully factored in, producing electricity from gas is more emissions-intensive than coal-fired power. Oil Change estimate the annual greenhouse gas emissions caused by the Atlantic Coast Pipeline to be almost 68 million metric tons - equivalent to the emissions from 20 average US coal plants or over 14 million passenger vehicles.

Along the 38 miles Appalachian ridgelines, between 10 and 60 feet of the mountain tops will be removed to make way for the ACP. Not only will it be reprehensible to affect fully forrested and ancient mountain ridges, but also numberous dump-truck-loads coming from these mountain ridges will further pollute the local environment (EcoWatch).

Since the beginning of the project, Indigenous people have led protests against the companies behind the pipeline for downplaying and ignoring their concerns (Thinkprogress). Families that have been resident in the affected areas for hundreds of years claim to have been misled by letters that did not sufficiently inform them about the project's purpose and impacts. The pipeline will run through many areas where racial and socioeconomic marginalization is occurring on a large scale. 

18 organisations and groups, including several indigenous tribes, have joined an appeal filed in federal court by the Southern Environmental Law Centre. They state that FERC made a mockery of the legal process, since they allowed Duke and Dominion to supplement their application for approval of the pipeline after the comment period had ended. Subsequently, the public had no change to respond (Facing South). The issue has been passed on to the Economic and Social Council of the United Nations (ECOSOC) in Geneva, Switzerland, who will determine if international human rights law is being violated (Farmville Herald).