This article discusses experiences from construction of pressure relief wells under flowing artesian conditions in the downstream of the Karkheh storage dam. Based on the information obtained from monitoring wells installed in the downstream of the Karkheh dam, indicating excess uplift pressure beneath the dam, construction of relief wells was exploited to relieve part of these pressures. The mentioned excess water pressure was produced in a confined conglomerate aquifer bounded above and below by relatively impervious mudstone layers. Further, the water level in the confined aquifer was about 20 m above the ground surface, resulting in artesian conditions. It is known that drilling and installation of relief wells in flowing artesian aquifers is significantly more complex and difficult than that in unconfined aquifers. In addition, such process in large dam sites having giant reservoirs like Karkheh storage dam would be associated with more complexities. In total, 23 relief wells were constructed in the downstream of Karkheh dam. Results showed that a successful process in such conditions requires the following items: drilling fluid to protect excavated walls, surface and driven casing, and grouting. Results indicate that these wells so far (January 2006) could be able to decrease artesian pressure about 25 m, improving the factor of safety by 40%.