This chapter illustrates the potential to advance transboundary water resources management in a more comprehensive approach. The focus is given to the transboundary Paso del Norte (PdN) region which is considered as the most environmentally damaged, hydrologically developed, and prolific irrigation area in the Rio Grande/Bravo Basin. Stakeholders from the US-Mexico PdN region provide insights into what needs to be done to foster sustainable adaptation of water allocation and management. A preliminary set of policy recommendations aims to highlight stakeholders’ preferences and interests and their integration into regional water resources management.