This paper provides an overview of the Italian water management system, with particular reference to the links between agriculture and water resources, and emphasis on underground resources. Our objective is mainly descriptive at this level; nonetheless, we try to evaluate patterns of interaction between agriculture and water resources policy from the point of view of water sustainability. After a short description of the main hydrologic and institutional aspects, the paper goes into the analysis of the most important issues and ongoing policies. We show that the link between agriculture and groundwater is but very weak in “Mediterranean” Italy. While most of the pollution problems regard Northern Italy – that resembles much more continental Europe than Mediterranean countries with respect to hydrologic and climatic patterns – the use of the water table for irrigation is restricted to only a few areas, since most of the agricultural water is derived from surface resources. On the other side, agriculture remains by far the largest water user in Italy, and one of the primary causes of pollution.