Environmental flows refer to the facets of natural flow regimes that are required to sustain riparian and aquatic life in a healthy condition, plus provide for the needs of those human uses that rely on, and do not compromise, stream health values. Environmental flow assessments are required for regulated rivers, where the flow regime has been modified, or flow volumes significantly reduced. The methodological trend has been from narrow studies that catered for a single fish species at one critical life phase to a holistic approach that aims to restore natural river processes. Consideration has also been given to the specific issues of flood flows required for wetland inundation and channel formation, needs of groundwater‐dependent ecosystems, the needs of estuarine ecosystems, and flows required for recreational activities. Holistic methodologies are particularly appropriate in developing countries with strong livelihood dependencies on the goods and services provided by aquatic ecosystems. The number of studies worldwide that report environmental flow recommendations greatly outweighs the number of studies that report scientific evaluation of the results of implementation of these recommendations. However, where implemented environmental flow regimes have been monitored, the results have generally been positive.