Water has always been a source of risks and opportunities in the Middle East and North Africa. Yet rapidly changing socioeconomic, political, and environmental conditions make water security a different, and more urgent, challenge than ever before. This report shows that achieving water security means much more than coping with water scarcity. It means managing water resources in a sustainable, efficient, and equitable way. It also involves delivering water services reliably and affordably, to reinforce relationships between service providers and water users and contribute to a renewed social contract. Water security also entails mitigating water-related risks such as floods and droughts. Water security is an urgent target, but it is also a target within reach. A host of potential solutions to the region’s water management challenges exist. To make these solutions work, clear incentives are needed to change the way water is managed, conserved, and allocated. To make these solutions work, countries in the region will also need to better engage water users, civil society, and youth. The failure of policies to address water challenges can have severe impacts on people’s well-being and political stability. The strategic question for the region is whether countries will act with foresight and resolve to strengthen water security, or whether they will wait to react to the inevitable disruptions of water crises.