Latin America and the Caribbean are relatively well endowed with water resources. However, population growth and rapid urbanization are putting considerable pressure on water available for irrigation. Local and regional water scarcity problems are exacerbated by severe water quality problems; and wastewater is frequently used for irrigation. Moreover, prospects for new investments into irrigation development appear limited. This paper examines the factors underlying irrigation development in Latin America and the Caribbean, reviews the water supply situation, and describes trends in water demand and irrigated agriculture. The overall water management in the region is assessed, and recent trends in investments in the water sector, with a focus on large-scale irrigation systems, are analyzed. The paper concludes that in this context of accelerating demand and declining irrigation investments, new water development is not the primary solution to water resource challenges in the region. Much greater attention is needed on water policy and management reform to improve the efficiency and equity of irrigation and water supply systems. In order to pay for future investments, irrigated agriculture needs to produce high-value crops for both local consumption and exports into competitive world markets. Policies to officially transfer management responsibilities from agencies to farmers - and to privatize urban water supply and sanitation - are increasingly important. The complex tradeoffs across sectors and across water uses can best be managed through integrated water management at the river basin level—but developing appropriate institutions for intersectoral water allocation remains an important challenge under the fragmented management structure in most of Latin America and the Caribbean. Thus, the challenges for water policymakers in the region are great, but a strategy that focuses on river basin management, irrigation management transfer and privatization, and market-based water allocation can effectively address these challenges.