The Khmer people, inhabitants from antiquity of the geopolitical region now principally demarcated by the Royal Kingdom of Cambodia, together with successive dynasties and governments have sought to stabilise and expand their precarious biomass-based subsistence-level village centred livelihood. This has generally comprised ‘rainfed-lowland rice-based farming systems’. The paper is structured as follows. Section one briefly surveys Cambodia’s agrarian development gap. Then section two overviews the Government’s rehabilitation and development mission as undertaken since 1993. Section three outlines Millennium Development Goals and specific Cambodian programs to improve rural household access to safe water. Section four describes the country’s climate and overall water resources. Next, advances over recent years in expanding access to groundwater in Cambodia and the scientific assessment of such resources are detailed in section five. This is followed in section six with an account of concepts, indicators and indexes of access to water. The sustainable livelihoods approach and household water economy model are described in section seven and applied to Cambodia. Section eight provides an account of foreign NGO water project management and administration, goals and objectives. This is followed by concluding comments in section nine.