Over the next few decades, the challenge of water scarcity is expected to grow more acute as water demands from the power generation, agriculture, industrial, and municipal sectors all increase. Energy production requires copious amounts of water, with the volume of water used by power generation ranking second only to that used for agriculture. This article reviews options for managing the water requirements associated with power generation. Although the effects of both existing and emerging modes of power generation on water use trends are explored, the primary focus is on thermal systems, which account for the majority of existing capacity.