Integrated River Basin Management (IRBM) has been a long discussed way to sustainably manage water and land resources; yet, very few examples of effective IRBM are found because there is a lack of sufficient scientific support, as well as institutional accommodation, to successfully implement it. This paper overviews the major challenges with IRBM, the promising scientific approaches for the implementation of IRBM, and the areas of needed research, with considerable issues and experiences from China. It is expected that novel research will draw together disparate disciplines into an integrated scientific framework, upon which better modeling tools, stakeholder involvement, and decision-making support can be built. Cutting-edge new technologies will bring ideas of IRBM forward to theory and finally to practice. The paper will prompt scientists to undertake research to fill in the gaps in the current IRBM knowledge base and provide practitioners guidance on how to incorporate scientifically based information within the IRBM decision process.