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A preliminary and detailed botanical survey of the islands in the Mekong River between Kratie and Steung Treng was done. This area includes the most biologically intact and threatened riparian and terrestrial ecosystems along the river in Cambodia. The vegetation includes six riverine zones and four terrestrial facies. Riverine habitats are mostly intact while the terrestrial vegetation ranges from destroyed to degraded. Effective conservation measures are required to stop further habitat destruction and loss of biodiversity. One new species, 23 records for the Cambodian flora, and a total of 690 species were collected. Detailed descriptions of all habitats, a database, and photographs are included. Increased exploitative human settlement in the area has caused drastic environmental changes with extensive deforestation and hunting. The forests are grazed, burned, logged, and often cleared for agricultural use without effective control. Sustainable management and scientifically acceptable development must be implemented before the area is totally ruined. Properly conceived reforestation is urgently required as well as a conservation education project aimed directly at the people living in the area. Unless effective restraints are implemented the area will become biologically destitute and will not be able to provide the natural resources that people require--in short, the area will become uninhabitable. Restoration of degraded or destroyed places will be impossible or far more difficult than conservation and intelligent management of presently endangered places. The potential for profitable eco-tourism should also be considered since tourists will certainly want to visit natural ecosystems on some of the islands. Only if local people are directly involved in eco-tourism and understand the necessity of conservation can this activity be successful. It is strongly recommended that continued botanical research be conducted in the area in order to more fully understand the distribution and abundance of the plants there. © 2009 by Maejo University, San Sai, Chiang Mai, 50290 Thailand.