As the world’s population increases, so does the pressure on water resources to ensure that agriculture continues to meet global food demand. One way of coping with this increased pressure is to improve the management of surface water resources for irrigation, for instance to reduce water losses in large canal systems. This chapter presents a number of different strategies for improving and securing surface water irrigation systems. If irrigation schemes are to be sustainable, factors such as stakeholder commitment, sound design and efficient operation and maintenance must be ensured. Advanced irrigation technologies – such as sprinklers and drip irrigation systems – must be considered, along with decision support tools to assist farmers and managers in optimizing water allocation to different crops. The capacity of water institutions must be enhanced in order to solve entitlement, pricing and regulatory issues. It is concluded that reforms should aim at solving the underlying management issues, as well as delivering benefits to the people.