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The wetlands of the Amudarya River delta in Uzbekistan provide valuable ecosystem services to the local human population which has suffered severely from the loss of the Aral Sea, desertification and the post-soviet socio-economic transition. The region is also particularly vulnerable to the impacts of climate change as a recent severe drought has shown. In this contribution, we assess the potential and implications of incorporating environmental flows into management of the Amudarya River for improving the provision of wetland ecosystem services and enhancing resilience of the social-ecological system to river runoff uncertainty. Our assessment is based on analyses of 1) the current vulnerability of deltaic wetlands to years of low water availability, 2) expected regional climate change and its impact on water flows to the wetlands, and 3) alternative water use options to enhance environmental flows under a changing climate. The results provide a ranking of these options with respect to their benefits for the provision of environmental flows and implications for agriculture. Their realization, however, poses challenges that cannot be tackled by technical interventions of redistribution and efficiency increase alone but call for institutional changes and moves towards multi-purpose water use. The diversification of impacts and livelihood options would allow enhancing the resilience of the social-ecological system to climate or socio-politically induced changes in water flow. (C) 2013 Elsevier B.V. All rights reserved.