This article reviews why agricultural water management projects have failed or succeeded in improving livelihoods, and provides recommendations to enhance the outcomes and impact of investments in AWM. Agricultural water management (AWM) strategies have been extensively studied and promoted in Burkina Faso during the past four decades. However, rainfall variability and water access continue to limit agricultural production of most of the smallholder farming systems of the country. Our goals in this paper are: (i) to review the evolution of AWM development with respect to the technologies promoted, while emphasizing the context, approaches, investments and outcomes; (ii) to explore the linkages between the evolution of AWM projects, their outcomes and their impacts on rural livelihoods; and (iii) to provide recommendations to enhance the impact of new development initiatives. Between 1970 and 2009, 195 bilateral and multilateral AWM projects were implemented in Burkina Faso, corresponding to an investment of US$ 641 million.The study of the evolution of these projects allows one to assess the reasons for their success or failure. While projects involved many technical solutions, their actual impact on livelihoods is debatable. Using an outcome–impacts framework, the authors provide recommendations for enhancing the effectiveness and sustainability of investments in agricultural water management.