Lake Ohrid is one of the oldest and deepest lakes in Europe. It represents an ancient ecosystem formed as a result of the unique landscape and stable ambient conditions, which allowed many plants and animals to evolve rapidly into new species and some others to survive unchanged through centuries. Lake Ohrid and Lakes Prespa together form the Lake Ohrid Watershed Region due to their interconnection via rocky channels under the mountain Galichica. They both originated from the geotectonic depression during the Pliocene epoch. The estimated age of Lake Ohrid is two to three million years, and as such can be considered as one of the oldest lakes in Europe. More importantly, the exceptional conditions developed in this lake allowed for homing of 212 endemic species, 186 of which are animals. Ten out of seventeen fish species in Lake Ohrid are endemic. The rest are represented by snails, worms, and sponges. The ratio of the number of endemic species over water surface only proof the status of this lake, not only as national but also as an international treasure. Today Lake Ohrid spreads its water surface in two countries: North Macedonia and Albania. Both countries have responsibility for protecting the lake and for conservation of its uniqueness. There are three major cities established along the shore and many other villages and settlements. In terms of water quality, we can differentiate between natural and anthropological impacts on it. Natural impact on the water quality is represented by inflow or outflow rivers which can bring or take deposits and other nutrients. However, the human influence on the water is much greater and of higher significance. People have since long ago used the water for agriculture, industry, maintenance of public hygiene (sewerage), tourism, etc. This undoubtfully brings its own burden to the whole ecosystem in the lake and therefore must be sustained and well-managed. Unfortunately, the socio-economic conditions through the years led to violation of the natural environmental conditions in the lake, and have subsequently caused rapid aging of the water, noticeable by the increased nitrification. There is now, urgent need to protect further damaging of the whole watershed and to conserve this one-of-a-kind lake – home to an impressive number of endemic species valuable for the entire humanity. Therefore, we as a community have elucidated the causes of stress and have proposed several strategic goals and actions for short and long time periods, accordingly. (Todorche Spasov, Republic of North Macedonia, JICA-ILEC Knowledge Co-creation Program, Preliminary Action Plan, October 2019)