In this article, social-economic, legal and ecological perspectives on effectiveness of water quality governance and their interactions have been studied. Worldwide, authorities are facing the challenge of restoring and preserving aquatic ecosystems in accordance with the United Nations Sustainable Development Goals (SDG 6). Over the last few decades, governance approaches have often been used to realise these ambitions. To date, scholars have identified that it is difficult to relate governance approaches to water quality improvement and have offered several different explanations for this. Combined with a targeted conceptualisation of the perspectives and their interactions, the systematic literature review demonstrates the gap that exists in the current understanding of these interactions and what their effects are on water quality improvement, especially in regard to the identification of ecological issues and their boundary conditions for the legal framework and the development of measures and follow-up. The review also reveals that the scientific debate is focused on the planning rather than implementation phase. A step forward can be made by supplementing existing analytical frameworks by the interactions between the different perspectives, especially those related to problem definition and the development and realisation of measures.