In South Asian countries such as Nepal, India, and Bangladesh, pollution of rivers is more severe and critical near urban stretches due to huge amounts of pollution load discharged by urban activities. The Bagmati River in the Kathmandu valley, the Yamuna River at Delhi, and peripheral rivers (mainly Buriganga River) of Dhaka suffer from severe pollution these days. The observed dry season average of biochemical oxygen demand (BOD) in all these rivers is in the range of 20-30 mg/liter and total coliform are as high as 104-105 MPN/100 ml. Per capita pollution load discharge of urban areas has been estimated to be about 31, 19, and 25 g BOD/capita/day in Bagmati, Yamuna, and the rivers of Dhaka, respectively. Regression analysis reveals pollution loads steadily increasing nearly in step with the trend in urbanization. The dissolved oxygen (DO) level of the Bagmati and Buriganga rivers is declining at an average annual rate of nearly 0.3 mg/liter/year. Unplanned urbanization and industrialization occurring in these cities may be largely responsible for this grave situation. Inadequate sewerage, on-site sanitation, and wastewater treatment facilities in one hand, and lack of effective pollution control measures and their strict enforcement on the other are the major causes of rampant discharge of pollutants in the aquatic systems.