The Latin America and Caribbean region is water-abundant. It boasts some of the world’s largest rivers, lakes and aquifers, which yield more water per person than any other region in the planet. However, water is irregularly distributed in time and space due to climatic variability. While heavy rainfall takes place across the year in the Amazon rainforests, it barely ever rains in the Atacama Desert. Besides, the majority of the population is concentrated in cities. This generates strong asymmetries between water demands and water availability. Largely as a result, many freshwater ecosystems are endangered by a wide array of different pressures. Adaptation to climate change, universal access to water and sanitation services, pollution control and an integrated approach to transboundary water resources management are the main challenges ahead.