The fewer the water resources, the greater the demand and the more important water becomes. This applies in Egypt, where rainfall is rare and most of the country is desert, except for a narrow strip of cultivated land and urban areas along the Nile river course. Like other large rivers, the Nile Delta region is characterized by large tracts of rich fertile agricultural land, overpopulation and unique and delicate environmental conditions caused by mixing drainage and freshwater. Managing these unique natural resource areas has become increasing critical, given the threat to the ecological balance in these areas due to an increase in water exploitation to boost population and the development of resources. Accordingly, the performance of water-delivery systems, particularly irrigation systems, must be clearly defined and assessed under these current or expected stressed conditions. This paper highlights irrigation, drainage and water-management projects in Egypt and presents the positive and negative effects as well as the role of government and users in operating and maintaining the system. The objective is to identify significant research programs and projects carried out over the last three decades that have impacted on irrigated agricultural practices in Egypt. The study documents both successful and failed cases of direct and indirect research uptake. Specific recommendations for increasing the research uptake, improving the penetration of research results and taking corrective measures to strengthen and encourage research uptake to irrigation and drainage practices are highlighted.