Abstract: Integrated management approaches in an area of increasing water stress is mandatory for conflict prevention and a good optimization of the common use. A combination of equitable political cooperation with balanced management practices can surely maintain a sustainable economic growth. Among the main international water bodies, the Mekong River is the largest in Asia. Its management approaches face different challenges. This paper aims to define the objectives and principles implemented by the different countries surrounding the Mekong River and to highlight the achievements through effective management projects.