The literature addressing the extent to which freshwater is infused with the potential for conflict, and the implications of lack of water availability, can be broadly divided into two schools of thought. The first approach is that of ‘neo-Malthusianism’, whose proponents contend that freshwater scarcity is pervasive and growing, and will be an increasing irritant to interstate relations in the future and a salient cause of conflict. In contrast, the ‘Cornucopians’ argue that scarcity is an eminently soluble problem, that a host of technological, innovative and institutional remedies can be brought to bear to alleviate scarcity, and that collaboration and cooperation, not conflict, has been and will be the norm in interstate relations over shared water resources. Evaluating both theories, I find that neo-Malthusians offer a more plausible account of future interstate water relations in the Middle East. Growing physical constraints to water supplies and the shortcomings of current technological and institutional mechanisms for easing scarcity will continue to render access to freshwater a likely flash-point of future antagonisms in the region. Despite the rapidly approaching natural limits to consumption of available water supplies, the adoption of several key policy interventions by Middle Eastern states and/or the international community may well alleviate water scarcity to an appreciable degree, and prevent intensifying competition over scarce water resources from erupting in violent conflict. These policy options and their merits are discussed and justified in the final section of the article.