In view of the features of flood disasters, it is pointed out that the dramatic development of urbanization over the last twenty years in the Taihu Lake Basin contributes to the significant changes of the features of flood risk. Therefore, flood control and disaster mitigation are facing significant pressures and challenges in the basin. It is pointed out that actively promoting flood risk management in the Taihu Lake Basin is an inevitable choice and a direction toward improving the safeguard level of water security. The practices of flood risk management in different stages are summarized. New situations that flood risk management is facing in the basin are evaluated. Finally, the thinking and prospects for flood risk management in the Taihu Lake Basin are both provided.