The doubling of global food demand by 2050 is driving resurgence in interventions for agricultural intensification. Globally, 700 million people are dependent on floodplain or coastal systems. Increased productivity in these aquatic agricultural systems is important for meeting current and future food demand. Agricultural intensification in aquatic agricultural systems has contributed to increased agricultural production, yet these increases have not necessarily resulted in broader development outcomes for those most in need. Here we review studies of interventions that have sought to improve productivity in aquatic agricultural systems in Bangladesh, Cambodia and Zambia. We review evidence of development outcomes from these interventions and the particular role of participatory approaches in intervention design and deployment.