Irrigated arid and semi-arid regions of the world account for more than 40% of the global crop production. Managing soil health while simultaneously increasing water use efficiency in these areas is challenging, but critical to future global food security. This chapter describes production practices such as no-tillage and surface residue preservation that maximize both water infiltration into soil and soil water retention, reduce runoff and evaporation and thereby increase the productive flow of water via transpiration. The chapter summarizes recent information on the application of soil health management principles in irrigated and dry land arid and semi-arid environments, including examples of cost–benefit trade-offs associated with reduced-disturbance no-tillage systems and the use of cover crops. The chapter looks ahead to future trends in this area and suggests further reading for those interested in researching further.