Water use, its impacts and management, have become a focus of attention in the past decade in the context of climate change and increasing consumption (in particular of food and agricultural products) due to a growing global population. Many efforts have been made to include water-related issues in life cycle assessment (LCA) in various ways, from the long-standing eutrophication, acidification, and ecotoxicity methods, to the more recent water consumption aspects. Four years on from the first discussion forum on water in LCA (35th Swiss Discussion Forum on LCA, Zürich, 5 June 2008), numerous developments have occurred, resulting in a rich palette of approaches. Significant challenges still remain, related to the complexity of water systems and ecosystems, and certain impacts are still not considered. New challenges have emerged, such as how to fit these “pieces” together to form a coherent and comprehensive approach for assessing the impacts of water use (both degradative and consumptive). Practice has started to apply certain water consumption-related approaches and an early feedback between practitioners and developers is essential to ensure a harmonious further development. The 50th Swiss Discussion Forum on Life Cycle Assessment (DF-50) gave a brief overview of the current status of water use in LCA, and then focused on the following topics in three main sessions: (1) a selection of recent research developments in the field of impact assessment modeling; (2) identification of new and remaining challenges where future effort could be concentrated, with a focus on spatial and temporal resolution; (3) and experiences and learnings from application in practice. Furthermore, several short presentations addressed the issues of inventory requirements and comparison of impact assessment approaches. The DF-50 was concluded with a discussion workshop, focusing on four issues: which degree of regionalization is desirable, how to address data gaps in inventories, the comparability of different impact assessment approaches, and the pros and cons of including positive impacts (benefits). Numerous recent developments in life cycle impact assessment have tackled impact pathways, spatial and temporal resolutions, and uncertainties. They have lead to an increase of the completeness of impact assessment, but also of its complexity. Although developments have also occurred in inventories, the gap between impact assessment and inventory is challenging, which in turn limits the applicability of the methods. Regionalization is confirmed as an essential aspect in water footprinting; however, its implementation requires concerted effort by impact assessment developers and software developers. Therefore, even though immense progress has been made, it may be time to think of putting the pieces together in order to simplify the applicability of these tools: enabling the support of improvements in companies and policy is the ultimate goal of LCA. The recordings and presentations of the DF-50 are available for download from www.lcaforum.ch.