The concept of sustainability has a key component of balancing developmental needs of the present and the future, what we call the time element (TE). Integrated Water Resources Management (IWRM) has emerged as a paradigm of river governance, balancing different interests and needs. This we call the Interest Element (IE). This paper explores how IWRM incorporates sustainability, leading to stronger river governance, reflecting the balance between timeframes as well as across different interests. We investigate the use of indicators for integrated assessment of two large river basins, the Yellow River basin in China and the Ganges River basin in India. The process analysis method is employed for developing framework. A tailored indicator set is selected and categorized under three domains, environmental performance, social wellbeing, and economic development. This framework provides policy-makers with a holistic review of river sustainability through tailored indicator sets, which can be used for underpinning IWRM policies. This speaks to our argument that an explicit recognition of sustainability indicators, resulting in a composite model makes for both conceptual clarity and better policy directions. This paper concludes with a series of key elements for IWRM through a comparative study of river management regimes in China and India.