The Mekong region is undergoing rapid transitions, socially, economically, and environmentally. Economies are stabilizing after the political turbulence of the last several decades, and development pressures as well as ambitions are vast. Water is related to these social, economic, and environmental changes in many ways and in a very profound manner. This article summarizes the approach and major conclusions of the research project title “Integrated Water Resources Management (IWRM) on the Mekong River.” The concept of IWRM is elaborated in the setting of these major transitions, and the roles of academic research and education are highlighted.