Abstract: This paper reviews several recent case studies in which states or countries have strengthened their protection of environmental flows to explore the key policy, stakeholder, and scientific elements that contributed to these advances in water management. A conceptual framework is developed to describe the actions of interest groups and individuals, how environmental flow issues get onto the formal agenda of decision makers, the events and conditions which precipitate this attention, the role of science and scientific uncertainty, and how interactions and dialog among individuals and groups with different interests lead to changes in state and national statutes. In general, the review found that changing policies is a result of actions of informed groups of interested parties using science and information to inform both the public and decision makers about the need for action and about the specific action needed. In almost all cases, environmental flow issues make it onto the formal agenda of institutions through one or more precipitating events, often legal challenges that call into question the existing legal framework for water management. Significantly, in almost all cases the engagement between advocacy coalitions with different and often opposing views results in reframing the issues to provide a common approach or solution upon which the competing coalitions can agree.