Until the last two decades, the global perception of how to control our various water bodies was remarkably similar – water management was organised on a sectoral basis, as it always had been. It was only in the 1970s that the people actually responsible for implementing water management began to become aware of the serious implications of such an approach: water quality deterioration, desiccation and an alarming loss of the flora and fauna that characterised their local water environment. It was a growing awareness that led to the formation of the concept of integrated water management, a concept almost universally accepted today as the way forward. However, despite the fact that few dispute the validity of the concept, a number of obstacles remain before this theoretical agreement can be transformed into practical action. Three main bottlenecks stand in the way of implementation: institutional, communicational and socio-political. Whilst solutions to these are available, the key question still to be answered is whether society is really prepared to accept the consequent changes in the way we live that will result from putting the theory of integrated water management into practice. It was this issue that dominated the “Living with water” conference held in Amsterdam in September 1994. The following is a summary of the discussions held there and the various papers that were submitted.