This book assesses river health in the Lancang River Basin with regard to the impacts of hydropower projects. It studies key components of the transboundary effects of Chinese dams on the Lancang River including its hydrology, sediment transport, water temperature, and fish community. It also investigates the specific impacts of hydropower on women’s lives and livelihoods, and factors that influence women’s participation in river health management. In closing, the lessons learned regarding environmental protection and hydropower development in the Lancang River Basin are shared, e.g. with hydropower developers and regulators in Laos.