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The need for an integrated management of water resources has derived from the emerging understanding that the water crisis cannot solely be regarded as a hydrological crisis. Instead, it is frequently defined as a crisis of governance, as institutional and management scarcity are hindering a sustainable, equitable and efficient use of water resources. Integrated Water Resources Management (IWRM) is internationally accepted as a toolbox to achieve these objectives. However, implementation of the IWRM-approach is still lacking, especially in developing countries and transitional economies. This study poses the central question of what kind of governance is necessary to achieve an integrated management of water resources. Evaluating the concept from a regional perspective, three case studies have been conducted in Yemen, Jordan and Syria to identify the main governance challenges during the IWRM-process and develop strategies on how to meet them, aiming to improve the practical applicability of the theoretical framework of IWRM in the Middle East.