The Adige River, Italy’s second-longest, flows 409 km from the Alps to the Adriatic Sea, covering a 12,100 km² basin across multiple regions. Home to 1.6 million residents, the basin is heavily influenced by tourism, which exacerbates resource pressures. The region faces complex challenges in managing water, energy, ecosystems, and food production, driven by factors such as hydropower’s impact on downstream flow, agricultural demands, and a lack of guaranteed ecological flow amid water scarcity. Additionally, saltwater intrusion and climate change-induced shifts in seasonal water availability add further complexity to sustainable resource management.