<p>Protected areas play an important role in ecosystem conservation and climate change adaptation. However, no systematic information is available on the protection of high elevation freshwater ecosystems (e.g.&#160; lakes, glacierized catchments and streams), their biodiversity and ecosystem services. Here we addressed this issue by reviewing literature and analyzing maps of protected areas and freshwater ecosystems in the tropical Andes. Overall, our revision and inventory indicate: <strong>1)</strong> seven national parks were created with the objective of water resources protection, but they were not designed for freshwater conservation (i.e., larger watersheds), and mainly protect small ecosystems. Furthermore, the creation of new local protected areas was needed for water resources conservation; <strong>2)</strong> we quantified 12% and 31% of lakes and glacial lakes are protected, respectively. Around 12% of the total stream length is protected. First-order streams predominate in the study area, of which 14% are protected. Furthermore, 29% of glacierized catchments (average surface of 677 km<sup>2</sup>)<sup></sup>are protected, and 46% of the total glacier area is protected. We quantified 31 Ramsar sites; <strong>3) </strong>high-value biodiversity sites have not been protected, and ecosystems services information is limited. This review highlights the need for future research to fill knowledge gaps for effective freshwater conservation actions.</p>