Lake Kivu is one of the African Great Lakes lying in the Albertine Rift. It provides livelihoods to 5.7 million people living in the two riparian countries of the Democratic Republic of the Congo and the Republic of Rwanda. Lake Kivu is currently experiencing numerous stressors, including fish habitat destruction, pollution, invasive species, weak governance and law enforcement as well as conflict between riparian countries. One of the biggest challenges on Lake Kivu is the limitation of coordinated and consistent research on the lake. Scientific attention to large lakes is often not seen as a high enough priority by the riparian countries, despite the lake sustaining millions of people’s livelihoods, and contributes to the GDP of both countries. Although we have a fair understanding of the basic geology, physics, chemistry, and biology of the lake, there is a need for stronger long-term monitoring and research frameworks to gain more comprehensive understanding of the changes resulting from human uses and global warming. These would be needed to develop good policies and management decisions for sustainable and long-term health and use of the lake’s resources. This manuscript presents an opinion of experts on what is known about the current lake’s current status and its resources as well as about what should be done. It highlights key threats, issues and gaps that needs to be urgently addressed, and provides specific and strategic ways forward for long-term monitoring and management, essential to achieving a healthy Lake Kivu, able to sustain its dependents.