Hydropower development with concomitant changes in water and land regimes often results in livelihood transformation of affected people, entailing changes in intra-household decision-making upon which livelihood strategies are based. Economic factors underlying gender dimensions of household decision-making have been studied rigorously since the 1970s. However, empirical data on gender and decision-making within households, needed for evidence-based action, remain scarce. This is more so in hydropower contexts. This article explores gender and livelihood-related decision-making within rural households in the context of hydropower development in Lao PDR.