The Indus River dolphin (Platanista gangetica minor) is a freshwater cetacean that occurs only in the Indus River system in Pakistan and India. This review provides a comprehensive summary of issues surrounding Indus dolphin conservation, and includes a description of their distribution, the threats they face and a discussion of conservation and research activities, options and priorities. Information was gathered from published current and historical literature, newspaper articles, and unpublished reports. Prior to construction of the Indus Irrigation system dolphins occurred in 3500 km of the Indus River system. Their range has now declined by 80% due to fragmentation of river habitat by barrages and large-scale diversion of water for irrigated agriculture. The sub-species was estimated to number approximately 1450 individuals in 2011, and occurs in 6 subpopulations, three of which are probably too small to persist. There is an urgent need to evaluate whether dolphins move through barrages, as this has the potential to extirpate upstream subpopulations. Prerequisites for dolphin translocations to combat this problem are outlined. Mortality in fishing gear and high levels of chemical pollution in water courses are both increasing threats exacerbated by depleted flows. Research and conservation priorities include maintenance of river flows, mortality monitoring, canal rescues and community-based conservation. Conservation and research action is urgently needed to prevent the Indus dolphin from succumbing to the same fate as the baiji.