The 1993 Environmental Action Programme for Central and Eastern Europe presented a series of recommendations for integrating environmental objectives into the process of economic and democratic reform in Central and Eastern European countries (CEEC) and the New Independent States of the former Soviet Union (NIS). In this paper, on the basis of findings of a recent OECD study, we look at progress across the region in light of these recommendations. In several CEEC, there has been a synergy among economic reforms, democratic development, and environmental improvement. These countries have seen important improvements in environmental conditions but now face a variety of challenges, many tied to the process of accession to the EU and the need to deepen integration between environment and sectoral policies, such as those for agriculture and transport. In other countries, and in particular many NIS, pollution reductions have mainly resulted from declines in economic production. Many of these countries face ongoing crisis in terms of establishing economic reform, stable societies, and environmental protection. In several areas of the former Soviet Union, environmental problems—in particular poor access to safe drinking water—pose serious threats to human health. Addressing these problems presents a difficult challenge both for national governments and for international cooperation agencies.