The Vietnamese Mekong River Delta (VMD) is the world's third-largest delta, located in the Lower Mekong Basin. Situated in the humid tropics, the VMD has favorable conditions for diverse tropical agriculture, which has been experiencing a dynamic transformation from primary production to strategically commercial production, providing the whole nation with food security and exports. However, past successes of extensive growth have come at environmental costs, including changing natural hydrological regimes, deforestation, depletion of natural resources and biodiversity, land degradation, land subsidence, water pollution, drought, and salinity intrusion. In the face of climate change and complex upstream developments, it is recommended that agriculture in the VMD follow a transformation pathway that includes nature-based agricultural land use change, circular agricultural and agroecology, combined green and gray engineering, and market-based agribusiness in order to ensure environmental and socio-economic sustainability.