People clearly need and benefit from healthy freshwater ecosystems; Given the precarious state of these important systems and services, current efforts to address the freshwater biodiversity crisis remain insufficient. Planetary health is an emerging framework that aims to secure the state of natural systems within environmental limits that ensure humanity can flourish. The planetary health concept is tied to the planetary boundaries framework in which various ecological thresholds are identified with the goal of constraining human activity to within those boundaries (so-called safe operating spaces). Freshwater systems are influenced by some planetary-scale processes like the climate systems and phosphorus and nitrogen cycles. Nonetheless, safe boundaries to guide the conservation and management of freshwater ecosystems need to consider their uneven distribution around the globe, and their ecological and hydrologic limits, which are often site and context dependent. Efforts to down-scale planetary boundaries concepts to the management of freshwater recreational fisheries at the lake scale, suggest that there are opportunities for rethinking planetary health as a nested cross-scale approach from the planet to the watershed.