The distribution of water resources in Vietnam is highly variable both geographically and seasonally. This variability, coupled with the fact that almost 60% of the country’s water resources are generated outside of its borders, creates an unstable resource base and associated management challenges. Water shortages during the dry season and poor water quality are acute issues, exacerbated by below-cost pricing and excessive subsidies. For government, the reform of water pricing and related fiscal policies, coupled with improvements to governance, regulation, and the use of development finance provide a means to scale-up financial resources, to internalize environmental externalities, and to shift patterns of behaviour to increase the efficiency and effectiveness of water resource use. In turn, these efforts can contribute to increased productivity, reduced poverty, and improved social equity while managing water sustainably for all.