Australia is the world’s driest inhabited continent. It is therefore not surprising that places where fresh water accumulates either permanently or seasonally—our aquifers, rivers and wetlands—are of particular ecological and cultural significance. These inland water environments are also the places where we get the water needed to sustain us, our way of life, and our development as a nation. Perhaps no other single dimension of the Australian environment has such a ‘coming together’ of biological, cultural and economic values. This chapter assesses the state and trend of inland water environments resulting from historical development pressures, and the outlook for these environments given the emerging pressures we face.