This review attempts to: (i) present the Mekong regional characteristics (geography, topological settings, climatic conditions, hydrology, demographic features and the anthropogenic activities), (ii) present the different factors that endanger the LMR, including the dam’s impacts, the climate change, the delta subsidence, and the degradation of the water quality, (iii) make comparison with different big rivers around the world and (iv) promote future decisions in order to minimize the negative impacts and seek for a trajectory that assures well-being and sustainability.

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