Lake Sarez, which is located in the Pamir Mountains in Tajikistan, was created in 1911. A massive landslide, triggered by an earthquake, blocked the Murgab River valley, creating a natural dam, which was called Usoi. In 1999, the International Decade for Natural Disaster Reduction Secretariat led a mission to assess the risk and impacts in the Pamir Mountains of Tajikistan including this natural phenomenon. This report presents the final results of the assessment and offers practical recommendations. The areas of coverage include: geotechnical assessment of the Usoi landslide dam and the right bank of Lake Sarez; environmental impact assessment; flood scenarios; monitoring and early warning systems; accessibility of the Bartang River valley and Usoi Dam; Human geography/demography; and social and economic conditions in the valley of the Bartang River.