This paper analyzes one of the key factors for understanding the region of Central Asia: its distinctive relationship to water resources and how states in the region co-operate—or should do so—in order to achieve better management of this valuable resource. Section I introduces the general legal context and, after the presentation of factual data, examines the management of water resources in the region from the viewpoint of the obligation of co-operation established under general international law, including the realization of the right of access to water and sanitation by all citizens. Subsequently, we analyze how and to what extent current international co-operation tools might contribute to solving existing challenges. To this end, we explore both co-operation in the generation and distribution of hydroelectric power in the region, and regional co-operation in the management, conservation, and sustainable development of the inland fisheries of Central Asia.