Anthropogenic pressures such as river infrastructure, agriculture and power generation are rapidly increasing in Southeast Asia, aimed at providing food security within the region. However, this will lead to unintended river health consequences, and, currently, most Southeast Asian countries have no country-specific tools for monitoring river health. In Myanmar, one of Southeast Asia's poorest and most rapidly developing countries, no country-specific tools exist, and there is an urgent need to provide tools that can inform better management and trade-off decision making. This research evaluated three rapid macroinvertebrate bioassessment methods under Myanmar conditions. The objective of the research was to assess the applicability of existing internationally accepted indexing methods for use in Myanmar. Through taxa identification in the laboratory and statistical analysis, it was concluded that the method with the best fit for Myanmar taxa is The Asia Foundation index method, although differences were small. This Asia Foundation method is comparable to the AustralianWaterwatch method but includes a family present in our samples that is not included in the Waterwatch method. We then modified this method to include Myanmar taxa not recorded in The Asia Foundation method. The modified index method could be further developed into a Myanmar specific tool for widespread use potentially in combination with the also tested miniSASS, a much easier order-based method better suitable for non-professionals. We recommend additional testing using sites on other rivers across the country to establish a professional indexing method for Myanmar.