This report presents the assessment of the GIWA Eastern Equatorial Pacific region, which includes parts of Mexico, Guatemala, Honduras, Nicaragua, Costa Rica, Panama and Colombia. Pollution in the Southwest Mexico sub-system, freshwater shortage in the Central Equatorial Pacific sub-system, and the unsustainable exploitation of fish and other living resources in the Pacific Colombian sub-system were considered as the priority concerns. The root causes of these water-related problems are identified and policy options are proposed.