Throughout its long history, China is among the world's most flood-prone and consequently the most experienced countries in coping with floods. This is a dissertation about developing a historical approach for understanding regional dynamic change of vulnerability to flood hazards in the Chinese context, and providing an analytic base for the country's shift of its flood management strategy from the current predominant and prevalent flood control approach to a broader and more comprehensive risk management paradigm. The dissertation asks two central questions: (1) How can the changing vulnerability situation be better understood and analyzed so that the insights gained are most relevant for policy and practice? (2) What are the plausible pathways and key options for managing future flood risks in China in the context of rapid socioeconomic transition and climate change? By developing an analytical framework and a case study in the Dongting Lake area of China, and by outlining three fundamental dilemmas and three plausible pathways for managing future flood risk in China, the dissertation concludes that China needs a new flood management strategy--one that centers on vulnerability reduction and resilience building and one that embraces and internalizes variability and uncertainty in decision making. While a resilience strategy embodies a wide range of opportunities for long-term sustainable flood risk prevention and mitigation, the dissertation argues further that China faces major dilemmas in managing its future flood risks. Trade-offs between economic development and flood vulnerability reduction and between cooperation and tensions across diverse actors and scales cannot be escaped.