This report analyses trends in agriculture for the US Southwest region, one of the most water stressed and productive agricultural regions in the world expected to face further water shortages in the future due to climate change and continued growth. It examines projected water risks by mid-century without additional policy action, and discusses the expected implications for the agriculture sector, based on a review of existing data and available publications. The region will likely continue to be a major agricultural producer by mid-century but will be affected by more variable and uncertain water supplies and increased water demand. Irrigated area is likely to decline, with lower value, water-intensive field and forage crops experiencing the greatest losses. Livestock and dairy are also especially vulnerable to water shortages and climate change. Trade and employment may be affected, although projections remain uncertain. Policy options can help mitigate these projected water risks, such as agricultural and urban water efficiency improvements, refined groundwater management, investment in water banks and recycled wastewater systems, and well-defined water transfers.