The fluvial network in South America is known for having one of the highest densities and widest geographical coverages in the world, but, despite this natural endowment, inland navigation still plays a rather marginal role in the transport of goods and passengers in the region. South America has not yet taken full advantage of its extensive system of navigable waterways and needs to better integrate them into the region’s transport network in order to cater for the ever-increasing demand for cargo and human mobility. Although the evolution of international transport in inland navigation has been positive over the last decade, the modal shares of inland shipping in the region’s international transport are less than one percent in terms of value and volume. Inland waterways are not only used for transport between the countries of the region, located along the river basins, but also are the first leg of international transport flows with other regions of the world. Examples of the latter are the natural resource exports (soybean products, aluminium, and oil related products) from the Paraguay-Paraná, Amazonas, Plata, Orinoco and Magdalena river basins that are destined for Europe, the US or Asia. In these cases, seagoing vessels are directly deployed from the ports along these river systems. While the values of these exports have more than tripled since 2002, in some waterways the volumes have shown a decreasing tendency over the last years but hopefully not everywhere as in Paraguay-Paraná IW. In South America, there are several independent inland waterway systems, which have different levels of development. For some of these systems and from a macro perspective view, the uses of the inland waterway systems in the region are challenged by various factors.