Over the past two decades, irrigation has been a vital and integral part of agricultural and rural development programs throughout Lao PDR. Areas under irrigation have more than tripled from 0.15 million ha (Mha) in 1991 to 0.46 MhA in 2014. Unlike many other parts of Asia, the irrigation potential of the country has yet to be fully realized, with adequate land and water for expansion and intensification in most provinces. Continued investments in irrigated agriculture are forecast in coming years, as reflected in the current (8th) National Socio-Economic Development Plan for 2016-2020 and related high level policies and plans. The plans are ambitious, but also recognize the major challenges that constrain irrigation system management. Field observations and assessments are revealing mixed performance and a host of technical, economic, institutional and environmental issues are as yet unaddressed. There is a shared understanding that sustainable irrigation development and management implies intervention and guidance in, at least, four specific areas: i) improving market orientation and opportunities; ii) climate change adaption through improved water management; iii) informal private irrigation; and iv) ecosystem services protection and tradeoffs. These, and other areas, need careful consideration to support policy recommendations on the future development of the irrigated agriculture sector and related support services in Lao PDR.