This paper sets out to explore some of the practical aspects of the implementation of Integrated Water Resources Management (IWRM). The presentation has the following flow: 1. The relevance of IWRM for a number of key development issues; 2. The key characteristics of the concept; 3. The global status of IWRM 4. Practical implementation - the challenges; 5. Practical implementation - case studies showing successful applications to problematic management scenarios; 6. How IWRM programmes are being linked with the Millennium Development Goals (MDGs) and adaptation to climate change by the setting of achievement milestones.