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Abstract Dam construction and operation are known to alter the hydrology of rivers and degrade riverine ecosystems. In recent decades, the call to reverse these negative impacts by re‐operating dams has become stronger. Dams can support riverine ecosystems by releasing environmental flows (e‐flows). Unfortunately, despite the development of numerous methodologies to determine e‐flows and optimise dam releases, actual implementation has not followed suit. Integrating e‐flow requirements in the design of new dams is relatively easier than changing operations of existing dams; however, re‐operating existing dams is essential to restore ecosystems and ecosystem services that have already been affected by the construction and operation of dams. This study provides insights into how e‐flows evolve from recommendation to practice through a systematic literature review on practical experiences to integrate e‐flows in dam operations. Sixty‐nine cases of successful dam re‐operation have been identified, ranging from the well‐documented case of the Glen Canyon Dam in the United States to less known cases such as the Katse Dam in Lesotho. We find that the most important factors that facilitate the successful implementation of e‐flows are the existence of e‐flows legislation or policy, the development of a research base in the form of an environmental impact study, and then flow experimentation. Illustrations of the important role of collaboration between various stakeholders and set timelines for implementation of recommendations are also given. These insights will inform how existing dams can be re‐operated and governed more equitably and sustainably for both humans and the environment.