This article deals with the development of irrigated agriculture in the Upper Indus Basin of Central Ladakh in Northern India. Artificial irrigation, fed by meltwater from glaciers and snow cover, forms the backbone of regional food production in this semiarid Trans-Himalayan environment. Following an integrated socio-hydrological approach, we present 2 local case studies on the village level and an overview of Central Ladakh based on multi-temporal remote sensing analyses, qualitative interviews, and regional background information. The remote sensing analyses reveal both persistence and change of land use structures over the past 4 decades. In order to understand the characteristics and variations of this land use system, the role and influence of different stakeholders are analyzed. We show how land use dynamics reflect the interplay of local practices and external interventions in mountain development.