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Hydroelectricity was, for many years, one of the main ways to meet the new electricity needs of Latin American countries. This is evidenced by the presence of some of the larger plants worldwide and the high hydroelectric participation in all electricity matrices (Figure 1). Faced with growing prospects for future economic development, an underlying concern is how to respond to the important and growing demands for electricity. In several countries, governments and electric companies have opted to continue with the construction of hydropower plants, especially large-scale ones, as the main means of meeting this challenge. However, major projects formulated in recent years have been put in check by various difficulties, some even stopped. Despite the different political, regulatory, and economic conditions that exist in Latin America, there are common elements in the difficulties faced by these projects. While in the past, large-scale hydroelectricity was the successful response to higher electricity consumption, societies have changed, and this technology faces new cultural, social, and political conditions.