Water scarcity is a media darling often times described as a trigger of conflict in arid regions, a by-product of human influences ranging from desertification to climate change, or a combination of natural- and human-induced changes in the water cycle. A multitude of indexes have been developed over the past 20 years to define water scarcity to map the “problem” and guide international donor investment. Few indexes include groundwater within the metrics of “scarcity.” Institutional communication contributes to the recognition of local or regional water scarcity. However, evaluations that neglect groundwater resources may incorrectly define conditions as scarce. In cases where there is a perception of scarcity, the incorporation of groundwater and related storage in aquifers, political willpower, new policy tools, and niche diplomacy often results in a revised status, either reducing or even eliminating the moniker locally. Imaginative conceptualization and innovative uses of aquifers are increasingly used to overcome water scarcity.