This paper is a synthetic overview of some of the threats, risks, and integrated water management elements in freshwater ecosystems. The paper provides some discussion of human needs and water conservation issues related to freshwater systems: (1) introduction and background; (2) water basics and natural cycles; (3) freshwater roles in human cultures and civilizations; (4) water as a biosphere cornerstone; (5) climate as a hydrospheric ‘game changer’ from the perspective of freshwater; (6) human-induced stressors’ effects on freshwater ecosystem changes (pollution, habitat fragmentation, etc.); (7) freshwater ecosystems’ biological resources in the context of unsustainable exploitation/overexploitation; (8) invasive species, parasites, and diseases in freshwater systems; (9) freshwater ecosystems’ vegetation; (10) the relationship between human warfare and water. All of these issues and more create an extremely complex matrix of stressors that plays a driving role in changing freshwater ecosystems both qualitatively and quantitatively, as well as their capacity to offer sustainable products and services to human societies. Only internationally integrated policies, strategies, assessment, monitoring, management, protection, and conservation initiatives can diminish and hopefully stop the long-term deterioration of Earth’s freshwater resources and their associated secondary resources.