This chapter engages with the impact of urbanisation on river water drawing on evidence from three non-metro contexts in the state of Tamil Nadu. It explores four themes: the impact of urbanisation on water sources; the effects of the changes to water bodies on different users, especially women; the state interventions to restore water bodies; and the role of courts in shaping Zero Liquid waste Discharge (ZLD) policy. The chapter shows the ongoing patterns of urbanisation in river towns are adversely affecting women, increasing their work burden. Additionally, the chapter highlights amongst others the importance of managing land and water as a unified system. Contemporary State practices of urban development have a predominant focus on land, and water-related issues such as conservation, protection of water sources and equity in distribution are overlooked. Further, current strategies for financing urban development view land primarily as an economic resource for extracting wealth and not as an ecological resource. It is argued that this inherently promotes mindless conversion of land and erstwhile water sources for speculative urban real estate. The chapter concludes by noting that, although the significance of incorporating ecological aspects of planning is acknowledged in planning theory, it is yet to be translated into practice.