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The world's big rivers and their floodplains were central to development of civilization and are now home to c. 2.7 billion people. They are economically vital whilst also constituting some of the most diverse habitats on Earth. However, a number of anthropogenic stressors, including large-scale damming, hydrological change, pollution, introduction of non-native species and sediment mining, challenge their integrity and future, as never before. The rapidity and extent of such change is so great that large-scale, and potentially irreparable, transformations may ensue in periods of years to decades, with ecosystem collapse being possible in some big rivers. Prioritizing the fate of the world's great river corridors on an international political stage is imperative. Future sustainable management, and establishment of environmental flow requirements for the world's big rivers, must be supported through co-ordinated international funding, and trans-continental political agreement to monitor these rivers, finance their continual upkeep and help ameliorate increasing anthropogenic pressures. To have any effect, all of these must be set within an inclusive governance framework across scales, organizations and local populace.