<p>Water scarcity presents an ever-growing challenge in global agriculture, with major implications for food security. In the USA, the scale and complexity of the agricultural system magnify these challenges, calling for an integrated and adaptive approach to water management. Hence, we reviewed six key strategies aimed at sustainable agricultural water management — crop distribution optimization, soil management, modern irrigation technologies, water treatment and reuse, reduction of water demand in animal agriculture, and minimizing food loss and waste — identified based on their prominence in recent literature and potential to address water scarcity. In examining these strategies through a multidimensional lens, several challenges have emerged, including gaps in the current structure of incentives, psychological barriers, lack of awareness, reluctance to alter existing farming practices and consumption habits, and insufficient data on the effectiveness of certain water conservation measures. By offering actionable insights into potential areas of improvement, this Review aims to contribute to the ongoing discourse on agricultural sustainability amid changing climate dynamics.</p>