Water savings techniques and experiences are crucial to the development pattern of almost all countries in the Mediterranean area, where both land and water are scarce resources limiting agricultural production and overall development of the region. In Italy, unfavorable climatic conditions and complex physiographic and morphological context have made necessary the centuries of initiatives and investments in land reclamation, flood protection works and irrigation, which required adequate legislation support favoring the cooperative and participatory approaches in land and water management. This report analyzes the evolution of the water policies and legal framework for land and water management in Italy, giving a historical outline of initiatives carried out during the last Century and, then, focusing on the recent regulatory and organizational setup. The experiences and functioning of the main institutions working in water sector are presented and analyzed, also in a comparative and descriptive approach, highlighting differences and level of responsibility.