The Rio+20 United Nations Conference on Sustainable Development marks 20 years since the historic Earth Summit1 that was instrumental in laying the foundations and charting the course for contemporary sustainable development. This report looks at the issues that pertain to the management, development and use of fresh water resources. Its starting point is in the Earth Summit’s Agenda 21 recommendation for an integrated approach to the management of water resources. This report demonstrates that while there is still a long way to go, progress towards the goal of sustainable water resources management is undoubtedly being made.