Infrastructure in the Amazon has prioritized national development and other interests, which were generally tilted towards extractive activities (mining, energy, agriculture/cattle) and domestic industrial policies (e.g., Manaus Free Zone) rather than needs of local populations or environmental concerns, such as maintaining and protecting the high diversity of terrestrial and aquatic ecosystems, resulting in an unsustainable, low-quality development process. A new paradigm is necessary for adapting existing infrastructure, and for planning and building future infrastructure, at both national and subnational levels. This new paradigm should be based on the concept of a spatial configuration and include the consideration of nature-based solutions and Indigenous and local knowledge (ILK).