The authors explore efficient use of water resources as one of the strategic trends for development of the Kemerovo region which can be achieved by developing regional water supply and drainage systems. Thus, the purpose of the study is to define the major trends for long-term development strategies of water supply and drainage in Kuzbass which will take into account potential risks and strategic threats and which will be aimed at realization of strategic opportunities of the region. The study is based on Dr. V.L. Kvint’s theory of strategy and strategizing methodology. The authors analyze the original state of the regional water resources in dynamics, the structure of water use, global and regional trends which affect the global water resources (an increasing lack of water resources in the world, primarily), growing digitalization of water resources management systems, water supply and drainage systems, and they estimate their impact on Kuzbass water resources. The authors use the results of the analysis to determine the strategic trends for developing water supply and drainage in Kuzbass: creating strategic reserve of fresh water in Kuzbass, increasing reliability and energy efficiency of water supply and drainage system of Kuzbass, incorporating high technology into water supply and drainage system in Kuzbass, production of branded bottled drinking water in Kuzbass. Such strategic approach will provide for efficient use of water resources in the long-term perspective.