With rapidly increasing investment in water control infrastructure (WCI) and a recently ratified agriculture development strategy that promotes integrated farming of high-value products such as fish, agricultural production, already fundamental to Myanmar’s economy, will be central to driving the countries’ socioeconomic transformation. Water planners and managers have a unique opportunity to design and manage WCI to incorporate fish and, in so doing, reduce conflicts and optimise the benefits to both people and the ecosystem services upon which they depend. Results from rice–fish culture experimental trials in Myanmar’s Ayeyarwady Delta are providing an evidence base for the importance of integrating fish into WCI, highlighting a range of both environmental and social benefits. By using less than 13% of paddy land area and through best management practices, existing rice productivity is sustained, alongside a 25% increase in economic returns for the same land area from fish. In addition, there are considerably more protein and micronutrients available from the fish produced in the system. Should these farming system innovations be adopted at scale, Myanmar stands to benefit from increased employment, incomes and nutritional value of farm plots (alongside associated reductions in pesticide pollution) and water use benefits.