We provide a short overview of the bottom-up, non-governmental organisation (NGO)-driven conservation efforts that go a long way towards implementing the Ramsar Convention on the ground in the Prespa basin in the Balkans. Encompassing two lakes, the transboundary Prespa basin is covered by three Ramsar sites. The lakes host significant endemism and internationally important breeding and wintering waterbirds. For over 30 years, the Society for the Protection of Prespa (SPP), a locally based NGO representing an international constituency, has successfully used the obligations, goals and objectives laid out by the Ramsar Convention. The SPP has led broader alliances, implementing and coordinating conservation action, initially on the Greek side and later at basin level, through an integrated ecosystem approach, multiparticipatory decision-making processes and transboundary collaboration. It has achieved substantial benefits for waterbird populations, especially pelicans, engaged in community-based resource management approaches and drawn support, mainly from international donors, to achieve progress in the wise use of the wetland. The established decision-making mechanisms in Greek Prespa, the long-term monitoring data on the wetland ecosystem and the operation of transboundary collaboration networks are also expected to contribute towards addressing ongoing challenges, such as eutrophication and adaptation to climate change.