The Rio+20 United Nations Conference on Sustainable Development marks 20 years since the historic Earth Summit that was instrumental in laying the foundations and charting the course for contemporary sustainable development. This report, based on an analysis of data from more than 130 countries, 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. It is intended to inform decision-making at the Rio+20 conference and follow-up global policy discourses. It will facilitate information exchange to enhance the coherence and impact of national efforts to improve water resources management and related work of the UN and other external support agencies at country level.