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Contrary to popular belief, West African countries, including those of the Sahel, do not lack water. They consume approximately 1% of their renewable resources every year. However, there are major problems in terms of availability at the desired time and place. The problem lies in the technical and financial difficulties of access to groundwater reserves of which very little is exploited today. These problems are for the most part regional, the essential water resources being the cross-border aquifer and river basins. West Africa has 28 transboundary river basins. The most important river basins (Niger River Basin, the Senegal River Basin, the Volta River Basin, the Lake Chad Basin and the Comoé River Basin) serve as examples to illustrate the interdependence of regional water resources. As water can also be a source of tension and conflict, this chapter presents positive examples of co-operation and experiences in joint management at the bilateral and macro-regional levels. It also invites to initiate some strategic thinking on subsidiary between the different levels of regional co-operation.