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Densely urbanized basins face a challenge to implement the concept of integrated water resources management at the river basin level. In these basins there is the interaction of different sectors of human activity, including transportation and housing, that need to be incorporated in the management system. Moreover, the frequently used interbasin transfer schemes impose a more encompassing management method. This paper proposes a new concept: the total urban water management. Under this new concept, integration is applied indistinctly to sectorial vectors (combining different water uses) and to the territorial vectors, in the sense of horizontally cutting across different jurisdictions on the territory. This new approach is applied to the case of the metropolitan region of São Paulo. As a result of the federative political system in Brazil, this region presents a complex institutional arrangement. Union and States are in charge of the administration of rivers and the municipalities are in charge of land use management. Hence, it is not enough to establish a water management system because the management of land use in the river basin impacts the water use in the rivers. A metropolitan management system, which includes municipalities and the State, is proposed to take into account all the aspects of an integrated management system. [ABSTRACT FROM AUTHOR]