Water is a basic human need and a basic human right. In situations of scarcity, decisions about access to water and use of water involve actors at the intergovernmental, governmental, regional, community and household levels and often become highly politicized. The needs and perspectives of large and small scale farmers, of small and medium sized enterprises, of households, of fisherfolk and of others who earn their livelihood from water can differ significantly. At the same time, level of commitment of the different actors to conservation practices and to protection of water resources from contamination may also vary and the question of whose interests prevail and receive top priority can create considerable tension. The most vulnerable members of societies . the landless and the poor . often have no voice in decision-making about water and their needs may be given little priority. This paper reviews current practices in water utilization and management in developing countries, focusing specifically on the gendered nature of water decision-making.