<p>Rivers are essential for supporting ecosystems and communities but face unprecedented pressures from modern development, pollution, and resource demands. The Anthropocene, the present-day geological epoch in which extractivist humans have become a dominant force shaping the planet, is characterized by alterations in hydrology, water quality, sediment dynamics, biodiversity, ecosystem services, and human welfare. To address these challenges, we propose a new paradigm of nurturing rivers focussing on reciprocity that involves caring for their health and resilience, as well as benefiting from their resources and services. The framework consists of four elements: (1) recognizing the intrinsic value and rights of rivers, (2) restoring and enhancing river connectivity and functionality, (3) advancing inclusive and adaptive governance of river basins, and (4) promoting a culture of respect and appreciation for rivers. Nurturing rivers is not only an ethical duty, but also a strategic opportunity to enhance human security and well-being in the Anthropocene. Therefore, urgent attention and action are required to adopt and implement this paradigm shift, ensuring the long-term sustainability of rivers and the ecosystems they support.</p>