A new methodology for determining a sustainability index (SI) for the management of river basins is developed. Sustainability is defined in terms of minimizing the long-term risks to supply and maintaining the ecological, environmental and hydrological integrity of a river resource. The SI procedure developed uses two groups of performance criteria. The first group is based on demand-supply deficits and measures the risk to water supplies. The second group is only applied to river demands and compares a river’s allocation to a target flow regime using the Range of Variability Approach (RVA) and the Modified Hydrological Alteration factor. The RVA measures differences in flow regimes and is used to compare a projected flow regime to a targeted flow regime. This is the first attempt to use the RVA to develop a sustainability index for river basin management. A combined sustainability metric for the system (SS) is also determined. The methodology is applied to an area including the Prescott Active Management Area (AMA) in north-central Arizona. Sustainability for the entire system is determined using the weighted sum of the sustainability indices. The methodology has been used to measure and compare the sustainability of two allocation scenarios for the Prescott AMA.