Patkar was a PhD scholar when she became immersed in work with tribal and peasant communities in the Narmada Valley in West India, threatened with submergence along with over 37,000 hectares of forests and farmlands due to the construction of a series of dams. In 1985 she founded the Narmada Bachao Andolan, a people's movement for river protection, transparency and participation in governance. The movement brought together tribal communities, farmers, fishers, and labourers, as well as environmentalists, human rights activists, scientists, academics and artists who stood for just development. It highlighted the project's social and environmental impacts, undemocratic planning and unjust distribution of benefits, bringing attention to the many hidden costs of large dam projects. She received the Goldman Environmental Prize in 1992, and was included in the 100 heroes of the 20th century by Time.