In hydro turbine design, fluid-structure interaction (FSI) may play an important role. Examples are flow induced inertia and damping effects, vortex induced vibrations in the lock-in vicinity, or hydroelastic instabilities of flows in deforming gaps (e.g. labyrinth seals). In contrast to aeroelasticity, hydroelastic systems require strongly (iteratively) coupled or even monolithic solution procedures, since the fluid mass which is moving with the structure (added-mass effect) is much higher and changes the dynamic behavior of submerged structures considerably. Depending on the mode shape, natural frequencies of a turbine runner in water may be reduced to less than 50% of the corresponding frequencies in air, and flow induced damping effects may become one or two orders of magnitude higher than structural damping. In order to reduce modeling effort and calculation time, the solution strategy has to be adapted precisely to a given application. Hence, depending on the problem to solve, different approximations may apply. Examples are the calculation of natural frequencies and response spectra in water using an acoustic fluid formulation, the determination of flow induced damping effects by means of partitioned FSI including complex turbulent flows, and the identification of hydroelastic instabilities using monolithic coupling of non-linear structural dynamics and water flow.