Dams have proven their usefulness in preventing and mitigating floods, and water scarcity and generating electricity. They are indispensable in present society. But at the same time, they cause serious ecological, social and economical problems. Consequently we have to live with a dams dilemma, but how? Dams are changing (natural) rivers. In the decision making process the qualities and values of (natural) rivers are structurally underestimated.. These are identified. It is not the dam but the river ecosystem that has to fulfil so many wishes at the same time. Therefore it is the watersystem (on the scale of a riverbasin), and not the dam that has to be focussed on. The dam is only an instrument for management. By constructing a dam, essential environmental boundary conditions are changed. These changes cause negative effects but in the mean time they are challenging because they offer new opportunities. Pre-condition is a holistic systemic approach relying on an integrated water resource management, instead of the current fragmentation in managing water. Growing ecological knowledge and practical application (eco-pragmatism) will therefore play an increasing important role in watermanagement. Directed ecosystem development of watersystem will become within reach. The aims for (water) management of rivers are summarised. The universal principles in watermanagement are identified and applied.. Alternatives are put forward. Finally some recommendations are formulated.