This paper presents a brief account, based primarily on available secondary sources, of the current status of drinking water supply and sanitation in rural Madhya Pradesh. With a discussion on the lopsided hydrogeological attributes of water availability and shortages, a regional analysis of issues of access, quality of water and sustainability has been attempted. A brief discussion on the poor sanitation coverage of rural households in the State has been attempted. In addition to the State’s role in enhancing the availability of water resources (through rainwater harvesting, for instance), a particularly disturbing aspect of unreliable database concerning water and sanitation sector has been underscored.