With ever decreasing potential for suitable new dam sites, sustainable use of existing water reservoirs is of paramount importance. In absence of appropriate measures, reservoir storage is continually reduced due to sedimentation. One option to remove sediment deposits is hydraulic flushing. During the flushing operation, bottom outlets are open and water and sediment released. Whether flushing successfully removes sediment depends on a number of factors, such as bottom outlets capacity, reservoir shape and water availability. Modelling is often used to assess viability of flushing for sediment management in the reservoir, as well as to design the operations and optimize their scheduling. One-dimensional numerical models are preferred for long term simulations, assessments on of a large number of scenarios, and optimization studies. Two- and three-dimensional numerical models and physical models can be used, each on their own or in combination as hybrid models, to understand local scouring near the gates and other details of operation. Monitoring of flushing operations can help improving their efficiency while at the same time limit downstream impacts. General monitoring of the reservoir and its catchment can help understanding the sedimentation problem and thus facilitate preparation of efficient sediment management strategies. Live monitoring of sediment concentrations is possible with modern equipment though not without challenges, and reservoir survey can be performed faster. Earth observation techniques are also an attractive option, allowing to monitor large areas and areas of difficult access, as well as to provide historical information going back several decades. This paper reviews monitoring and modelling approaches published in the literature, as well as presents some previously unpublished analyses.