The Myanmar hydropower sector, in the early stages of development, has the opportunity to develop sustainably by balancing electricity generation with environmental and social outcomes. The country is currently following a conventional hydropower development process, with individual projects identified and approved without due consideration of the overall cumulative impacts that multiple projects and other pressures have on the river basin. In many countries this process has resulted in most major rivers and tributaries suitable for hydropower being developed, regulating these watercourses for 50-100 years and beyond. Significant cumulative impacts on basin health and related ecosystem services have resulted, with minimal opportunity available to lessen these impacts. This Strategic Environmental Assessment (SEA) of the Myanmar hydropower sector considers environmental and social values at the river basin level, recommending an approach to achieve sustainable hydropower development. The SEA recommends moving the initial planning focus away from individual projects to basin health to plan a sustainable sector development.