From March 2001 to December 2003 eight direct count surveys in an upstream direction were conducted for Ganges river dolphins Platanista gangetica gangetica in the Vikramshila Gangetic Dolphin Sanctuary, a c. 60 km long segment of the middle Ganges River in Bihar, India. The mean number of dolphins recorded during upstream surveys was 119.4±SD 31.8 (range 88–174), with an encounter rate of 1.8 dolphins km−1 (range 1.4–2.8). During these surveys a rich diversity of other threatened aquatic wildlife was also documented, including the Indian smooth-coated otter Lutrogale perspicillata, gharial Gavialis gangeticus, a variety of freshwater turtles, and 135 water bird species. An assessment of fisheries documented 76 fish species of which 43% were caught exclusively in monofilament gill nets, a gear known to kill dolphins by entanglement. Eight new records of fishes preyed upon by Ganges river dolphins were identified from the stomach contents of two dolphin carcasses (Setipinna brevifilis, Osteobrama cotio cotio, Puntius sophore, Crosochelius latius, Mystus cavasius, Heteropneustus fossilis, Macrognathus pancalus, Sperata seenghala). These fishes and other species previously recorded in the diet of the dolphins composed 33.3% of the total catch sampled in 2001–2003. Interviews of 108 fishing households revealed that literacy rates were low (29.9%) and almost 50% earned less than USD 411 per year. The most important conservation actions that could be taken are for national and state governments to establish civil control and promote the development of community-based fishing cooperatives. These cooperatives could enjoy ownership rights to certain river segments in exchange for employing sustainable fishing techniques that are less injurious to dolphins.