This article investigates whether and how local livelihood issues are linked to international development policy and practices in the Mekong River Basin under a two-level game approach. Based on field research and interviews with villagers, and national and international policy makers associated with two hydroelectric dam projects, four key livelihood issues that are central to local communities, but are not currently considered important in international development policy and practices, are described. Fundamental to these issues is the problem that existing frameworks of international institutions do not consider local communities and citizens as legitimate participants at the international level. It is argued that the linkages between local- and international-layer institutions are not established by considering only policy issues and interests of nation-states; the focus of existing frameworks of international institutions. A major challenge for international development planning in the Mekong River Basin is establishing direct linkages between local livelihood issues and international development institutions.