Water sharing within the states/provinces of a country and cross-border is unavoidable. Conflicts between the sharing entities might turn more severe due to additional dependency on water, growing population, and reduced availability as a result of climate change at many locations. Pakistan, being an agricultural country, is severely water stressed and heading toward a worsening situation in the near future. Pakistan is heading toward water scarcity as water availability in the Indus basin is becoming critical. Being a downstream riparian of India and Afghanistan in the Indus basin, water availability depends on the releases of water from both countries. The Indus Water Treaty is governing the water distribution rights between India and Pakistan. However, there exists no proper agreement between Pakistan and Afghanistan and the construction of new dams on the Kabul River is another threat to water availability to Pakistan. Correct implementation of the Indus Water Treaty with India is required, together with an effective agreement with Afghanistan about the water sharing. In addition to water shortage, poor management of water resources, inequitable sharing of water, lack of a systematic approach, old-fashioned irrigation practices, and growing agricultural products with large water footprints are all exacerbating the problem. The water shortage is now increasingly countered by the use of groundwater. This sudden high extraction of groundwater is causing depletion of the groundwater table and groundwater quality issues. This water shortage is exacerbating the provincial conflicts over water, such as those between Punjab and Sindh provinces. At one end, a uniform nationwide water allocation policy is required. At the same time, modern irrigation techniques and low-water-footprint agricultural products should be promoted. A fair water-pricing mechanism of surface water and groundwater could be an effective measure, whereas a strict policy on groundwater usage is equally important. Political will and determination to address the water issues are required. The solutions must be based on transparency and equity, by using engineering approaches, combined with comprehensive social support. To develop a comprehensive water strategy, a dedicated technopolitical institute to strengthen the capabilities of nationwide expertise and address the issues on a regular basis is required to overcome the complex and multidimensional water-related problems of the country.