The strong desire for achieving self-sufficiency in developing and mostly water-scarce regions has endangered socioeconomic and environmental sustainability. South Khorasan is particularly exposed to such insecurities, largely due to its limited water resource endowments and its comparatively intensive agriculture. In this paper, we apply the water footprint accounting method (WFA) along with a regional input–output (IO) model to analyze the efficiency of the total (direct + indirect) water

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... umption in different economic sectors and water footprint of the region in 2011. Results show that agriculture is responsible for more than 95% of water consumption in the area, while it accounts for just 27% of value-added. Additionally, this sector has the largest contribution to water footprint composition (92%) when compared to other sectors. Three water-saving scenarios are simulated by the use of IO economic model and water footprint accounting method. Applying the proper cropping pattern has the greatest impact on water conservation with 348.46 Mm3 per year. A 10% increase in water productivity contributes nearly twice as much as reducing the exports and increasing the imports of agricultural crops by 10% in saving water with 115.23 and 65.49 Mm3, respectively. The most significant contribution in each water-saving strategy comes from the agriculture sector since it has the largest direct and indirect water-use coefficient. The results of this study can help local policymakers take appropriate measures to improve the efficiency of water resource utilization, taking into consideration social, economic, and environmental sustainability.