Irrigated lands in Central Asia contribute to 80% of crop production and play a pivotal role in ensuring food security in the region. In the face of significant water stress, Central Asia has nearly reached its limit for extensive expansion of irrigated agriculture. 80% of water resources are allocated to irrigation purposes. However, the efficiency of irrigated land and water use in the region remains critically low. 40% of water is lost due to filtration from irrigation canals, and over 50% of irrigated lands are afflicted by salinisation. To address these challenges, it is imperative to modernise irrigation infrastructure and attract investments for this purpose, including through Public-Private Partnerships. The implementation of effective tariffs for irrigation water, the widespread adoption of water-saving technologies, and the empowerment of water user associations in rationalising water and land resources are all essential steps. The transition to efficient water-saving methods will bolster the productivity of irrigated lands and the responsible use of irrigation water, thereby safeguarding water, food, and environmental security in the region. These measures are of utmost importance, especially in light of the anticipated reduction in the flow of the Amu Darya River.