Inland fish and fisheries play important roles in ensuring global food security. They provide a crucial source of animal protein and essential micronutrients for local communities, especially in the developing world. Data concerning fisheries production and consumption of freshwater fish are generally inadequately assessed, often leading decision makers to undervalue their importance. Modification of inland waterways for alternative uses of freshwater (particularly dams for hydropower and water diversions for human use) negatively impacts the productivity of inland fisheries for food security at local and regional levels. This paper highlights the importance of inland fisheries to global food security, the challenges they face due to competing demands for freshwater, and possible solutions.