The sustainability of development remains an academic concept unless it is linked to clear objectives that must be attained in given territories and to the management processes needed to achieve this. Management of the natural resources located within the area of a river basin is a valuable option for guiding and coordinating processes of management for development in the light of environmental variables. In order to turn environmental policies into concrete actions it is necessary to have suitable management bodies, which are normally very complex. The establishment of such bodies means generating a public/private system which is not only financially independent, socially oriented and sensitive to environmental aspects, but must also act in a democratic and participative manner. In the past, the idea of establishing bodies to guide the management of the natural resources of a river basin (especially water, of course); has aroused the interest of the countries of the region, with varying results. This interest has now become an urgent necessity, in view of the greater competition for multiple water use and the need to check pollution and manage the environment correctly. This article considers some of the essential elements which must be taken into account when proposing to set up such bodies, puts forward some concepts on management at the river basin level and identifies the various ways in which the subject can be approached, and offers some recommendations for improving policy formulation and the functioning of integrated systems for the management of water resources and river basins.