Water is a basic natural resource that plays an irreplaceable role in maintaining the integrity of the natural environment and promoting sustainable development. Socioeconomic growth and threats to water security have led to increasing attention to integrated water resources management (IWRM) in recent decades. China has introduced the most stringent water resources management system, the river chief system, and other water policies to explore and improve the institutional structure and mechanism of IWRM. This paper summarizes the general framework of IWRM, discusses its implementation status worldwide, and examines developing trends in its practice. The data show that:① with increasing awareness of the problems of fragmented water resources management, the concept of IWRM has gradually been accepted by the international community; ② by emphasizing the importance of integration in water resources management, IWRM promotes the optimization of enable environment, institutional roles, management measures, and reliable investments in water infrastructure to achieve balances among water efficiency, social equity, and environmental sustainability; ③ many countries have adopted the principles and framework of IWRM for policy making and institutional design, and have made substantial progress in water management practices; ④ international conceptions of IWRM and experiences with its implementation can provide inspiration and reference for the improvement of China's water resources management; ⑤ IWRM will be further promoted and implemented, and its application to the solution of specific water issues will be strengthened with diversified and dynamic characteristics. Despite the existing challenges, such as uncertainty and complexity of climate change and the water-socioeconomic nexus, the experience in IWRM and the improvement of water science will allow the further application of IWRM using a holistic, multidisciplinary, and sustainable approach to achieve sustainable development goals.