This chapter introduces the complex challenges of pursuing sustainability in the Mekong region. The region is experiencing rapid economic growth but also faces many social, environmental, and economic challenges. Climate change and regional integration are increasing interdependence across countries. While economic growth has improved livelihoods, pressures on natural resources and ecosystems are rising. Integrating social, economic, and environmental objectives to achieve long-term sustainability has proven difficult. This book examines these issues through case studies and policy analyses from the region.