<p>Many species of aquatic macrophytes rely on asexual reproduction to maintain populations and recover after disturbances. Stem fragments are relevant asexual propagules for numerous macrophyte species. I conducted a systematic review to compare reproduction via stem fragments with other reproductive strategies, and identify the mechanisms and agents driving macrophyte fragmentation, and the vectors of fragment dispersal. Reproduction via stem fragments offers some advantages over other strategies, because it is nearly aseasonal, fragments are produced in large quantities, and their production is less affected by disturbances compared to sexual reproduction. Fragmentation occurs through autofragmentation and allofragmentation. The latter is predominantly driven by water flow and wave action, although animals and humans also play significant roles. Most studies on macrophyte fragment dispersal highlight the importance of hydrochory (dispersal by river flow or wind-driven currents). While zoochory (dispersal by fish and birds) and anthropochory (dispersal through boating and plant trade) are likely important, they have received less attention. Changes in aquatic ecosystems, particularly those associated with rainfall dynamics and dam construction, can impact macrophyte metacommunities by altering fragment production and dispersal. However, most macrophyte species, especially non invasive ones colonizing tropical regions, remain understudied with respect to their ability to reproduce via stem fragments.</p>