Molluscs are among the most diverse and widespread animal groups in freshwater habitats. Unfortunately, like most freshwater taxa, they are decreasing dramatically and are now among the most threatened animals on Earth, with many species already extinct or on the brink of extinction. Here, we review our current knowledge on the biodiversity and conservation of freshwater molluscs using the concept of knowledge shortfalls. We focus on seven previously proposed key shortfalls to review and analyse existing knowledge gaps relating to (1) taxonomy, the Linnean Shortfall; (2) distribution, the Wallacean Shortfall; (3) abundance and population dynamics, the Prestonian Shortfall: (4) evolution, the Darwinian Shortfall; (5) abiotic tolerances, the Hutchinsonian Shortfall; (6) traits, the Raunkiaeran Shortfall; and (7) biotic interactions, the Eltonian Shortfall. In addition, we address a new shortfall, which relates to the application and effectiveness of conservation measures, including assessments, methods, funding, and policies, the Ostromian Shortfall. Based on our review, we provide recommendations and suggest pathways to overcome these existing shortfalls. This work also introduces the articles in this special issue of Hydrobiologia, which represent key contributions to the First International Freshwater Mollusk Conservation Society Meeting held in Verbania, Italy, in 2018.