This study investigates the seismic response of a horizontal axis wind turbine on two bottom-fixed support structures for transitional water depths (30–60 m), a tripod and a jacket, both resting on pile foundations. Fully coupled, nonlinear time-domain simulations on full system models are carried out under combined wind–wave–earthquake loadings, for different load cases, considering fixed and flexible foundation models. It is shown that earthquake loading may cause a significant increase of stress resultant demands, even for moderate peak ground accelerations, and that fully coupled nonlinear time-domain simulations on full system models are essential to capture relevant information on the moment demand in the rotor blades, which cannot be predicted by analyses on simplified models allowed by existing standards. A comparison with some typical design load cases substantiates the need for an accurate seismic assessment in sites at risk from earthquakes.