Wet Tropics Waterways engages partners, stakeholders, and community in the Wet Tropics region, to work together to improve waterway health, from the catchment to the Reef. As part of a network that produces annual Regional Report Cards, we contribute to the objectives in the Reef 2050 Long-Term Sustainability Plan. A gap in this reporting has been the assessment of social, cultural, and economic components, i.e., “human dimensions” of waterways. Recent initiatives by the Reef Regional Report Card Partnerships and the Queensland Office of the Great Barrier Reef, supported by the Reef Trust Partnership and CSIRO, have led to the development of human dimension indicators, and the implementation of new monitoring to address some of these critical information gaps. Here we present baseline data and results from our recent survey of 502 residents of the Wet Tropics region. Key findings include strong local values, reflecting residents’ appreciation for biodiversity, a range of ecosystem services, and industries dependent on regional waterways. However, perceptions of waterway health, threats and governance were highly varied, as was trust in the management institutions and waterway science. We discuss future uses of this new data, and ongoing challenges for regional waterway management.