The Indus River basin supplies water to the largest contiguous irrigation system in the world, providing water for 90% of the food production in Pakistan, which contributes 25% of the country's gross domestic product. But Pakistan could face severe food shortages intimately linked to water scarcity. It is projected that, by 2025, the shortfall of water requirements will be 32%, which will result in a food shortage of 70 million tons. Recent estimates suggest that climate change and siltation of main reservoirs will reduce the surface water storage capacity by 30% by 2025. The per capita water storage capacity in Pakistan is only 150 m3, compared with more than 5000 m3 in the United States and Australia and 2200 m3 in China. This reduction in surface supplies and consequent decreases in groundwater abstraction will have a serious effect on irrigated agriculture. Supply-side solutions aimed at providing more water will not be available as in the past. Current low productivity in comparison with what has been achieved in other countries under virtually similar conditions points to the enormous potential that exists. To harness this potential, Pakistan needs to invest soon in increasing storage capacity, improving water-use efficiency, and managing surface-water and groundwater resources in a sustainable way to avoid problems of soil salinization and waterlogging. Building capacity between individuals and organizations, and strengthening institutions are key elements for sustaining irrigated agriculture in the Indus Basin.