The role of East, South and Central Asia in the world development is shown. The current per capita availability of water resources is calculated for the countries of the region. It is found that on the whole for the territory under investigation the availability of water resources is more than twice as small as the world’s average indicator and that more than 1.5 billion people live in conditions of water stress and deficit. It is pointed out that by the year 2010 more than 70 % of the population lived in conditions of high pressure on water resources, and 225 million people lived under very high and critical water stress conditions. The current pattern of water use in the countries of Asia is calculated, the dominant role of the agrarian sector is identified. An analysis is made of the measures for increasing the water availability level of the population and the economy: an increase in agricultural productivity of water resources, waste water reuse, use of saline waters, and the construction of reservoirs. Attention is given to an active construction of dams by China in the upper reaches of the Mekong which is causing distrust and tension in downstream countries. Published statistics evidence of cooperation and conflicts in international basins of Asia. It is shown that in the 20th century the basins of the Indus and Ganges rivers experienced the largest number of water conflicts as compared to all the international basins of the world; information regarding an acute struggle for water resources in Central Asia is also provided. It is concluded that in view of an ever increasing deficit of water resources, cooperation is the only alternative for Asian countries.Keywords: water stress and deficit, pressure on water resources, pattern of water use, measures for increasing the water availability level, cooperation and conflicts in international basins.