The article with the title “The future of global river health monitoring” explains why river health and biodiversity are important for human and ecological well-being, but are threatened by human activities and climate change. It also discusses how global initiatives to conserve and restore ecosystems lack adequate representation and indicators of freshwater health. Against this background it proposes a global framework for monitoring river health and biodiversity, which stems from a set of recommendations for policy makers, researchers and scientists for its development and implementation by 2030, with the potential for further enhancement by 2050. For this, the article reviews existing approaches and indicators for river health assessment and presents data and technical gaps and opportunities for improvement.