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Interventions aimed at increasing water availability for livelihood and domestic activities have great potential to improve various determinants of undernutrition, such as the quantity and diversity of foods consumed within the household, income generation, and women’s empowerment. However, current evidence on the topic is diluted across many different publications. This paper aims to connect the dots and review the literature available on the linkages between irrigation and food security, improved nutrition, and health. We conclude that the evidence remains insufficient to draw broad conclusions due to the low number of rigorous studies that can be used to assess the linkages. Based on the limited evidence, six factors that should be taken into account in irrigation development to address nutrition and gender gaps with a focus on Africa south of the Sahara are identified: (1) food security and nutrition gains should be stated goals of irrigation programs; (2) training programs and awa