ABSTRACT Rivers are linked to urban health and sustainable development, and yet the literature emphasises environmental science and overlooks the human side. This article presents a human-centred study of urban health and sustainable development in northeastern Thailand in relation to the Mekong River. The study’s framework, the travelogue methodology, brings travel to urban areas near the river (Nakhon Phanom, Bueng Kan, Phon Phisai, Nong Khai, That Phanom, Mukdahan, and Ubon Ratchathani) into the research and knowledge generation process. Data collection in June and July 2023 included observation, photography, note-taking, travel-journaling, and conversations with urban adult residents, analysed in narrative writing. The findings adeptly link the Mekong River to diverse aspects of urban health and sustainable development, including physical activity, social cohesion, food supply and nutrition, water supply, heritage, religious practices, liveability, and sense of place. It also brings to the fore the many threats to the river and, therefore, to human health. By addressing the areas for improvement, future research and practice can build upon these findings to promote healthy, sustainable, and resilient urban environments along the Mekong River and beyond.