Even in the absence of climate change, freshwater ecosystems and the resources they provide for people are under great pressure because of increasing demand for water and declines in water quality. The imminent onset of climate change will exacerbate these impacts, placing even greater pressure on already stressed resources and regions. A plethora of national climate change policies have been adopted that emphasize structural adjustment in the energy sector and increasing carbon sinks. To date, most public debate on water has focused on the direct impacts of climate change on hydrology. However, there is growing evidence that climate change policies themselves may have substantial additional and negative impacts on freshwater resources and ecosystems and may thus result in maladaptation. To avoid such maladaptation, integrated, coordinated policy making is required. In this paper, national climate change policies from Australia, Brazil, China, the European Union (EU), India, Mexico, South Africa, Tanzania, and the United Kingdom are compared to: (i) identify where negative trade-offs exist between climate change policies and freshwater resources, (ii) analyze where institutions and structures exist to optimize integration among climate, water, and biodiversity policies, and (iii) provide a much needed overview from a broad selection of countries with a view to identifying further opportunities for theoretical exploration and testing. The synergies and conflicts among climate, energy, water, and environmental policies create additional challenges for governments to develop integrated policies to deliver multiple benefits. Success factors for better policy development identified in this assessment and synthesis include engagement of senior political leaders, cyclical policy development, multi-agency and stakeholder processes, and stronger accountability and enforcement measures.