Improving water management to meet future global needs will certainly require technical advances, but the main challenge is to integrate the viewpoints of diverse societal interests into decisions about allocation of water resources. The integration cannot be done solely by the market because it requires a balancing among interests which do not respond well to market forces, nor by the state alone because of institutional problems. The concept of “integrated water resources management” has been developed to provide the framework for the required balancing of interests, and, like similar concepts in industries other than water, it has a dual purpose ‐ to link stakeholders and apply best practices to management actions. To clarify the process of integrated water management, the paper focuses on two questions: who should lead integrated water resources management and who should pay for it? Several examples are given to illustrate a range of situations. The paper concludes with a call to improve paradigms of integrated water management, a proposition that water organizations should accept and budget for their external responsibilities as well as their direct missions, affirmation of the need for state and federal agencies to be involved with local interests, a call for better scientific and public information, and identification of the need for continued work to improve the process of integrated water management.