At present Uzbekistan uses about 42 km3 of transboundary river flow and 27 km3 of this is from the Amu Darya. Annual average flow entering the upper reaches of Amu Darya within Uzbekistan is over 60 x 10(9) m3, which is already contaminated, but significant adverse water quality changes occur downstream where the river is the main source of drinking water. After independence Uzbekistan made a commitment to transfer management of farms and the rural economy from the public sector to private hands. Living conditions have deteriorated severely throughout Uzbekistan, but rural areas have been hit hardest. Several studies and projects in Uzbekistan have adopted the integrated water management-based environmental approach. A structured public participation and consultation process was followed during these projects including a social and the environmental assessment. This paper presents the two case studies to illustrate the effects of uniting the potential of all interested participants to improve water management and environmental safety. Consultation between the two main groups of stakeholders is essential for the future of the water sector. There is substantial support for WUAs among all stakeholders, at all levels, including among those stakeholders who currently manage the existing system.