Hydropower investment is a priority in many developing countries, as a means to increase electrification rates and promote national development. However, neglect of dam-affected people's needs, can make them vulnerable to the multifaceted impacts of such projects. Using the case of Cambodia's first large dam, the Kamchay dam, this paper reveals social priorities of affected communities and institutional actors linked to environmental and social implications of large hydropower projects using a preference ranking method. Qualitative research revealed concerns among dam-affected communities which included energy access, livelihood changes, environmental impacts, access to natural resources and compensation. Results also reveal divergence between national and local priorities, which in turn brings about an unequal distribution of costs and benefits of the Kamchay Dam between urban and rural areas. The paper provides recommendations to policy-makers, NGOs and international organizations regarding governance issues, consultation processes and mitigation measures. (c) 2015 Elsevier Ltd. All rights reserved.