This book concerns itself with the specific management of groundwater as a component of integrated water management. It is predicated on the observation that groundwater is an often unnoticed and unacknowledged cornerstone in the foundation of many economic and environmental systems. It comes as no surprise that in many regions of the world, the groundwater resource base and the social, economic and environmental systems dependent on it are under threat from over-abstraction and pollution. What is equally apparent is that the evolution of effective management systems to address these threats will be a long-term process requiring both sustained political commitment and improvements in basic data and scientific understanding. Simple indicators, such as major land-use changes, long-term water-level declines and increases in salinity, and pathogens or key pollutants help signal the need for management. In many cases, immediate action to reduce pumping, control pollution sources, and collect more detailed data on aquifer dynamics is essential to avoid irreversible economic, social and environmental damage. Man-induced changes in groundwater conditions (circulation and aquifer status/configuration) often result in complex environmental and socio-economic impacts that are difficult to predict or remediate. Pollution and declines in water levels and water quality frequently affect the sustainability of groundwater-dependent uses, whether or not the resource base itself is threatened with physical exhaustion or severe degradation. In many cases, much more adaptive approaches to local resource management involving a high level of stakeholder participation are essential. Wherever possible, these should be effectively coordinated at the respective river basin and aquifer scales. The development of effective approaches will, in most cases, require a long-term process through which viable national, regional and local systems can evolve. Keywords: Water Management