This chapter emphasizes the vital role of water in alleviating multidimensional poverty (SDG 1) by enhancing agricultural productivity, ensuring access to safe drinking water, and restoring ecosystems. Recognizing water as an economic, social, environmental, and institutional good, the chapter advocates for integrated water interventions that support sustainable watershed management, equitable benefit sharing, and ecosystem service expansion. Using a case study from North Gujarat, India, it highlights how water infrastructure development can both reduce and inadvertently deepen inequalities, underscoring the need for sustainable, equitable water management strategies that promote healthier communities and resilient urban environments (SDGs 11 and 3).