The Vietnamese Mekong Delta (VMD) is a region of utmost importance to Vietnam’s national food security. However, the availability of required freshwater resources (from both surface and groundwater sources) is currently under great threats due to dry season salinity intrusion, surface water pollution, and over-exploitation of groundwater. Global climate change, sea level rise, and upstream and in situ development activities may worsen the situation. Assuming that adaptive management could be a promising strategy to address the increasingly complex and unpredictable water-related problems in the VMD, we design and apply a framework to identify the extent to which the governance regime in this region exhibits conditions that are likely to promote adaptive freshwater management. Using both primary and secondary data, our analysis reveals that the prospects for adaptive water management in the study area are limited since several conditions were not present. We observe among others limitations in vertical and horizontal integration and public participation, restraints in knowledge and information sharing, inadequate policy development and implementation, and insufficient diversification of financial resources. Following our findings, we conclude the paper with recommendations both for national, regional and local policy interventions and for future research.