This document discusses the need for adaptive and sustainable groundwater management. It begins by characterizing aquifer systems and risks. It then discusses challenges of managing groundwater in irrigated agricultural areas and the need for integrated, adaptive management policies. Case studies from Brazil, Argentina, Peru and other areas demonstrate issues like overpumping, pollution hazards and rising salinity. The document advocates for pragmatic planning frameworks, balancing community participation with administration. It stresses the importance of conjunctive use, numerical models, monitoring and financing management measures. Vertical integration and horizontal coordination are needed between different governing bodies. Urban groundwater also requires management to fill institutional voids and address impacts on infrastructure from an often overlooked resource.