Globally, the issue of water scarcity has received widespread attention. Water shortage is felt most severely in arid and semi-arid regions, which cover a significant portion of the Earth. Historically, these desert regions have developed creative ways of managing water sustainably. This chapter proposes that architects and urban planners can adapt indigenous ways of water management while designing buildings. Instead of arguing for wholesale adoption of these practices, it is suggested that adopting a transdisciplinary approach would augment benefits that both offer and widen the scope of implementation. Despite the challenges inherent in synergising these two forms of knowledge, it contends that fostering of trust and genuine engagement can overcome these hurdles. The case of Egypt demonstrates the potential of indigenous knowledge in sustainable architecture, on the one hand, and argues against its wholesale adoption in construction of modern architecture. Further, the chapter explores the potential of integrating indigenous knowledge with modern technology by bringing to the fore the example of Seville, Spain where a novel strategy of implementing qanats in a modern way has been applied. Consequently, the innovative application of this ancient water system lowered ambient temperatures, reduced dependence on energy, and provided adequate water supply, thereby promoting sustainability and liveability. Through these case studies, this chapter contends that bridging the gap between indigenous knowledge and modern technology would produce sustainable water management practices that preserve culture and enhance the quality of life of residents, in even the most arid and semi-arid regions.