In many of the world's river basins, the water resources are over-allocated and/or highly modified, access to good quality water is limited or competitive and aquatic ecosystems are degraded. The decline in aquatic ecosystems can impact on human well-being by reducing the ecosystem services provided by healthy rivers, wetlands and floodplains. Basin water resources management requires the determination of water allocation among competing stakeholders including the environment, social needs and economic development. Traditionally, this determination occurred on a volumetric basis to meet basin productivity goals. However, it is difficult to address environmental goals in such a framework, because environmental condition is rarely considered in productivity goals, and short-term variations in river flow may be the most important driver of aquatic ecosystem health. Manipulation of flows to achieve desired outcomes for public supply, food and energy has been implemented for many years. More recently, manipulating flows to achieve ecological outcomes has been proposed. However, the complexity of determining the required flow regimes and the interdependencies between stakeholder outcomes has restricted the implementation of environmental flows as a core component of Integrated Water Resources Management (IWRM). We demonstrate through case studies of the Rhône and Thames river basins in Europe, the Colorado River basin in North America and the Murray-Darling basin in Australia the limitations of traditional environmental flow strategies in integrated water resources management. An alternative ecosystem approach can provide a framework for implementation of environmental flows in basin water resources management, as demonstrated by management of the Pangani River basin in Africa. An ecosystem approach in IWRM leads to management for agreed triple-bottom-line outcomes, rather than productivity or ecological outcomes alone. We recommend that environmental flow management should take on the principles of an ecosystem approach and form an integral part of IWRM.Key words IWRM; ecosystem approach; environmental flows; implementation Approche écosystémique et mise en oeuvre de débits environnementaux dans la gestion intégrée des ressources en eau Résumé Dans de nombreux bassins du monde les ressources en eau sont surexploitées et / ou profondément modifiées, l'accès à une eau de bonne qualité est limité ou concurrentiel, et les écosystèmes aquatiques sont dégradés. Le déclin des écosystèmes aquatiques peut avoir un impact sur le bien-être humain en réduisant les services fournis par des rivières, des zones humides et des plaines d'inondation saines . La gestion des ressources en eau d'un bassin nécessite de répartir l'eau entre des acteurs concurrents, dont notamment l'environnement, des besoins sociaux et le développement économique. Traditionnellement, cette répartition a été pratiquée sur une base volumétrique pour atteindre des objectifs de productivité sur le bassin. Il est cependant difficile de répondre à des o...