The desalination choice in water resources management should not be solely based on apparent water budget deficits but also on perspectives of emergency needs to mitigate water shortages as a result of pollution or droughts. Consequently, desalination should be planned as an integral component of energy and water resources management strategy. The document highlights the realities in desalination needs for a country or a region and cautions that they be viewed within the context of optimal choice among alternatives in integrated water resources and energy planning. Acceptability of additional water production at higher cost is intuitive when rational policies are formulated to address priority issues in water resources and energy management. Energy-rich countries which devoted substantive resources to advancing the technology in water and power production have intuitively justified their decision on the basis of low cost available energy and their realistic objective to achieve water security. Such choices did not preclude rigorous analysis of integrated energy and water resources systems to ensure sustainable power and fresh water for enhanced welfare of their people over time.Management decisions concerning the choice of a desalination project relate, among other rules, to dynamics of the water balance, absolute minimum requirements of fresh water for all uses, uncertainties in energy prices and costs of emergency response requirements without such facilities over a 50-100 year time horizon.The paper focuses on natural fresh water supply mix in a country which is characterized by a wide range of uncertainties in availability and shifting marginal costs with drought severity. Inclusion of desalination as a deterministic water production option provides the means for reduction of uncertainties and associated high-cost emergency response needs. The justification for such choice is discussed. The decision is whether to build an integrated wastewater treatment/desalination plant if the risk of drought severities or fresh water scarcity will have an impact on the economy and health of people in a country or to continue piecemeal developments of marginal reserves in response to calamities. Economic and social costs of errors are taken into account. The presented methodology proposes alternative cost-effective integrated wastewater/desalination management schemes to avert environmental and economic catastrophes. The methodology is non-conventional, realistic and imposes requirements on management for deploying means and methodologies at the cutting edge of technology.