Integrated Water Resources Management (IWRM) has been defined by the Global Water Partnership (GWP) in 2000 as “a process which promotes the co-ordinated development and management of water, land and related resources, in order to maximize the resultant economic and social welfare in an equitable manner without compromising the sustainability of vital ecosystems.” The theoretical basis of the concept of IWRM is provided by the Dublin Principles, which were adopted in the UN Conference on Environment and Development (UNCED) in 1992. These principles recognize water as a finite, vulnerable yet essential resource, and an economic good, which needs to be managed with wide stakeholder participation with special emphasis on women. IWRM concepts have theoretical implications for heavy metal and other toxic contaminations, and provide guidelines for improving water quality. IWRM principles have been successfully used to curb or mitigate heavy metal pollution of water in Malaysia, South Africa, and other countries. The European Water Framework Directive (WFD) has incorporated several IWRM principles such as catchment-level programs. Case studies on the application of IWRM principles to heavy metal and metalloid pollution in Mongolia and Trinidad and Tobago are also provided in this chapter.