The economy's expansion stresses energy demand, while climate change pushes this demand toward renewable solutions.  Water is a vital source of many economic activities, and hydropower is considered a clean alternative to fossil fuel. These two trends drive hydropower expansion, which is predicted to increase by over 70% in developing countries over the following decades. However, this development may be paradoxy to sustainability. For example, hydropower plants can influence an ecosystem that sustains a livelihood and food supply. Further, hydropower plants can cause geopolitical tensions in transboundary rivers. This chapter aim to increase understanding of diverse aspects of sustainable paradox in such a case.