Floods, benign and destructive, are an important feature of the landscape, livelihood and culture of the greater Mekong region. In the main valleys and plains rapid economic and social development over the past several decades has altered the use of land and water in ways that profoundly affect vulnerability of households, firms and regional economies to flood events. Disaster risk reduction measures usually involve structural interventions in the form of walls, channel modification, diversions and storage dams. Institutional measures are designed to reduce risks to certain subsets of the population or places, like central business districts. The thesis explored in-depth this paper is that current flood management policies and practices in the Mekong region, often claimed to be about reducing risks, are often more about shifting risks onto already vulnerable and disadvantaged groups.