Although significant progress is being made in the development of water resources in India, problematic management issues remain despite increased funding, a sizeable resource base (though with remarkable spatial and temporal variation) and a vast land resource. A large population and increasing demand pose challenges for water resource professionals, and mean that India continues to struggle to meet its water requirements. A comprehensive review of the water sector was undertaken to provide perspectives on the way forward. Based on an extensive review of the secondary literature and five regional consultations with key stakeholders, the pressures and drivers in the sector were examined. These included changes in water availability and access, and the role of the State and water programmes, the community, market and civil society in providing access and control over water for the people. Recommendations are made and compared with two other significant sector reviews at a national and regional level. There is a broad consensus emerging from these three major reviews, in terms of the focus on key actions proposed; these are in the areas of water resources, drinking water and sanitation for health, data and knowledge, policy and institutions, and capacity and disaster management.