In many countries of the Global South, aquatic ecosystems such as streams, rivers, lakes, and wetlands are severely impacted by several simultaneous environmental stressors, associated with accelerated urban development, and extreme climate. However, this problem receives little attention. Applying a DPSIR approach (Drivers, Pressures, State, Impacts, Responses), we analyzed the environmental impacts and their effects on urban hydrosystems (including stagnant waters), and suggest possible solutions from a series of case studies worldwide. We find that rivers in the Global South, with their distinctive geographical and socio-political setting, display significant differences from the Urban Stream Syndrome described so far in temperate zones. We introduce the term of ‘Southern Urban Hydrosystem Syndrome’ for the biophysical problems as well as the social interactions, including the perception of water bodies by the urbanites, the interactions of actors (e.g., top-down, bottom-up), and the motivations that drive urban hydrosystem restoration projects of the Global South. Supported by a synthesis of case studies (with a focus on Brazilian restoration projects), this paper summarizes the state of the art, highlights the currently existing lacunae for research, and delivers examples of practical solutions that may inform UNESCO’s North–South–South dialogue to solve these urgent problems. Two elements appear to be specifically important for the success of restoration projects in the Global South, namely the broad acceptance and commitment of local populations beyond merely ‘ecological’ justifications, e.g., healthy living environments and ecosystems with cultural linkages (‘River Culture’). To make it possible implementable/practical solutions must be extended to (often poor) people having settled along river banks and wetlands.

Human welfare depends on the health of nature. Decades of ill-conceived management practices caused a decline in the quality of human life, as well as in biological and cultural diversity. Simultaneously, they increased social and ecological risks. For instance, mismanagement of urban rivers jeopardizes their ecological health and ability to provide ecosystem services. While demands for responsible urban riverscape design that fulfill both human and ecosystem needs are increasing, explicit recommendations to achieve these ambitious goals are still lacking. We present a first attempt of a conceptualization of Human–River Encounter Sites for urban rivers that targets reconciliation between humans and nature within urban river corridors. It builds upon the River Culture Concept with literature reviews and experiences from river restoration projects. We identify six tenets that are important to develop guidelines for Human–River Encounter Sites: health, safety, functionality, accessibility, collaboration, and awareness. This paper presents how these tenets can collectively help to harmonize the needs of citizens and biota, and to mitigate the current urban river crisis. This contribution feeds the debate on sustainable socio-ecological management of urban rivers and provides guidelines for the implementation of future urban river restorations and management efforts.