Rice farming is the dominating agriculture activity in the Mekong Delta and has been of significant importance for the region’s economic development, but it has also had an impact on the environment. Recent governmental policies emphasize the need for sustainable and climate-resilient agriculture; however, policy reforms pushing for transformation towards sustainable socio-agricultural systems are compounded by a lack of coherent and shared visions. Gaps between policy making and implementation and stakeholders’ divergent visions of what is meant by sustainable agriculture and how that can be achieved hinder progress. To address this, the Q-methodology was used to elucidate and integrate different perspectives from 41 stakeholders on 35 statements related to agriculture developments in the Mekong Delta. Under the theoretical lens of sustainability, and ecosystem services, the results unveiled four major development schemes, namely production through intensification, sustainable intensification, production through nature, and people and nature in balance. The majority of the stakeholders in this study believed that future agriculture strategies in the Mekong Delta should be designed to promote more diverse and integrated farming methods, emphasizing the environmental and social dimensions of sustainable development. They acknowledged the multifunctional benefits of rice field ecosystems and emphasized the importance of supporting, regulating, and cultural ecosystem services for a long-term and healthy production of food and increased resilience of the Delta’s social-ecological systems.