The Mekong River Basin possesses the region's largest potential water source and related resources, which support ongoing economic development and basin community livelihoods. It is currently witnessing a major demographic transition that is creating both opportunities and challenges. An analysis of the complex relationship between demographic changes and impacts on the natural-resource base confirms that resource exploitation is occurring not only to meet growing domestic needs but also for other vested interests. Population, together with other major drivers, such as institutions, markets, and technology, will have a very strong bearing on the way in which the rich resources of the Mekong River Basin are developed and distributed in the present and future. The Mekong River Basin's rich resources, and the benefits derived from them, are unevenly distributed both in time and geographically. Moreover, since the causes and impacts do not respect political boundaries, the Mekong countries need to jointly develop alternative management strategies to meet projected demands within the sustainable capacity of the Mekong River Basin natural-resource base.