The paper presents an overview of the present situation of the Mexico City Metropolitan Area (MCMA). The analysis indicates an urgent need to radically improve the current water supply and wastewater management practices, to become sustainable. The MCMA is one of the most rapidly growing urban centers of the world, with a population of about 21 million people, a very high rate of immigration and numerous illegal settlements. In order to meet the increasing water demand, successive governments have focused almost exclusively on supply management and engineering solutions, which have resulted in investments of hundreds of millions of USD and the construction of major infrastructure projects for interbasin water transfer. Environmental, economic and social policies associated with water management are mostly inadequate and insufficient, which is resulting in increasing deterioration in the environment, health and socioeconomic conditions of a population living in one of the largest urban agglo-merations of the world. Surprisingly, however, no long-term strategies on demand-management, reuse, conservation, and improved water-management practices have been developed so far.