This article deals with stakeholders' interactions and institutional capacity influencing water resource management where competitive demands co-exist. For the case study area of Axios Delta, Northern Greece, a water deficit in the agricultural sector, an unmet environmental flow and a reduced capacity for urban supply during drought conditions are observed. An egocentric network analysis based on desk-study and a series of semi-structured stakeholder interviews reveals how weak stakeholder ties lead to ineffective multilevel governance and, as a result, low water efficiency practices. There is a lack of understanding of other users' priorities as well as of the risks related to climate change and/or seasonal variability. This is reflected in the flat rate abstraction licence for agricultural purposes which reduces environmental flow to below acceptable standards. There is no transboundary cooperation between Greece and the Republic of North Macedonia which hinders an integrated management approach. A limited exchange of information to support an evidence-based allocation plan is observed. Suitable interventions identified through a DPSIR approach are evaluated in a multi-criteria analysis considering cost effectiveness, delivered benefits as well as ease of implementation. Suitable technical practices include the development of a local and catchment-scale monitoring network for surface water and groundwater, climate-adaptive agriculture and treated-water reclamation. Updated management policies involve the institutional prioritisation of environmental flow through an adaptive allocation plan as well as the strengthening of transboundary cooperation. This research shows how the coordination of aggregated diverging interests in multilevel multi-stakeholder environments appears to be key in supporting positive water budgets in an uncertain climate future.