This chapter examines the importance of geomorphic understanding of river dynamics for managing, restoring, and naturalizing rivers to achieve environmental objectives. Many management efforts are based on the concept of equilibrium adjustments among flow, sediment transport, and channel morphology that presumably lead to the development of stable channel forms. Overviews are provided of geomorphic assessment methods to inform management. Management of rivers is linked to human processes, especially within the context of stream naturalization, which emphasizes the social nature of policy and decision-making that underpins management. The discussion highlights how the setting of goals for management and actual management outcomes are fundamentally social processes. It also emphasizes that factors other than geomorphological considerations are vital considerations in environmental decision-making related to river management. The Natural Channel Design approach to river restoration is compared with process-based approaches. How rivers respond to the removal of dams is also considered. The discussion emphasizes the importance of a watershed perspective on river management.