The Blackstone River is a relatively small river that drains the area around Worcester, Massachusetts, one of first industrialized cities in the United States. Until the 1970s, the river was highly polluted by industrial and municipal wastewaters--not unlike the current situation in degraded rivers in areas of Central and Eastern Europe (CEE). Today, the Blackstone enjoys considerably improved water quality as the result of two historical processes: continuing investment and improvement in municipal wastewater treatment in response to increasingly stringent U.S. federal water-quality laws, and the control or elimination of industrial discharges. A key factor in the river's restoration was the early development of and continued adherence to a comprehensive basin water-quality plan. A similar planning process is recommended for CEE countries. Nonetheless, achieving acceptable water quality in the Blackstone was a slow process, requiring decades of intensive improvement in wastewater treatment. A similarly slow process can be anticipated in the CEE countries unless cost-effective interim improvements in wastewater treatment are sought.