This document examines the approach of managed aquifer recharge (MAR) in the upstream of Fergana Valley in Central Asia with a view to adapt to global and socio-economic changes. The study follows a stepwise procedure of implementing MAR in the Fergana Valley, starting from the regional assessment of the MAR potential to testing MAR at the pilot scale through field and modelling studies. This report proposes a major shift in the focus of development projects in the Fergana Valley, from rehabilitation of dense drainage systems to groundwater development for irrigation and MAR.