Monterrey metropolitan area’s growth has resulted in water transfers from the Río San Juan basin with significant impacts for downstream water users, especially farmers in the Bajo Río San Juan (BRSJ) irrigation district. El Cuchillo dam is the centerpiece of the basin’s water management infrastructure and has become the flashpoint of a multi-faceted water dispute between the states of Nuevo León and Tamaulipas as well as between urban and agricultural water interests in the basin. Subsequent to El Cuchillo’s implementation in 1994, the BRSJ irrigation district has been modifying its irrigation operations to adjust to the new water availability scenario. Compensation arrangements for farmers have been established, including crop loss payments on the order of US$ 100 per hectare un-irrigable due to the diversion of water to Monterrey plus 60% of the water diverted to be returned to farmers as treated effluent via the Ayancual Creek and Pesquería River, a process with its own water competition and environmental implications. The Mexican irrigation sector will continue to face intense competition for water given: (a) low water productivity in agriculture leading decision-makers to allocate water to higher productivity uses particularly in cities, (b) priority accorded to the domestic use component of municipal water supply, and in the BRSJ case, (c) Mexico’s national interests in meeting its water sharing obligations with the United States.