The impact of climate change on the availability of water affects all types of land use and sectors. This complexity calls for integrated water resources management and negotiations between sectors on the most important, cost-effective, and productive allocation of water where it is a limited resource. This reflection paper shows examples of adaptation efforts to water scarcity at a scale where gains in water productivity can be derived from intersectoral water reuse and wastewater–freshwater swaps, complementing other water scarcity coping strategies (water savings, long-distance transfer, and desalination). Wastewater treatment for reuse offers opportunities across scales as it allows, for example, donor regions to be compensated with reclaimed water for the release of freshwater for higher-value use, increasing overall economic water productivity in this way. In such water swaps, farmers are compensated with higher water volumes in exchange for higher quality. The reuse of water between sectors offers opportunities to (i) expand the traditional (agricultural) water productivity concept and (ii) significantly increase water productivity at the system level. While rural–urban water reallocation can help mitigate the impacts of climate change, compensating farmers with reclaimed water remains limited for the reasons discussed in the paper.