There are significant obstacles that have prevented a decided adoption of an integrated water management framework in Chile. This chapter provides an overview of how water management has evolved in Chile, showcasing the advances that have allowed its scope to gradually expand, moving from an approach limited to meeting certain sector-based requirements to a more comprehensive perspective. The limitations of the current institutional system are also analyzed, highlighting a number of existing challenges in water management, where the institutionality has been found to be incapable of providing suitable responses and an efficient and equitable management, in a framework of environmental sustainability, in view of the needs imposed by Chile's development. Finally, a number of basic elements that must be incorporated into the current legal and institutional framework in order to advance towards an IWRM in Chile are discussed.