A study conducted by Adelphi and CAREC within the framework of the Swiss Blue Peace Central Asia Initiative presents the cost of inaction related to water management in Central Asian countries. The region is experiencing growing competition over water resources and their use for irrigation and hydropower generation. Despite a general political commitment to cooperation, water policies in Central Asia are largely driven by uncoordinated and partly contradicting national strategies. This limited water cooperation, thus, entails significant costs and major risks for the future development of the region. The study highlights the scenarios for the future development of regional water cooperation and provides the estimations of the respective “costs of inactions” for the status quo scenario.