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Long-term investments in agricultural water management (AWM) interventions in the Volta and Limpopo river basins have aimed at improving water availability and quality for smallholder farming systems. However, sustained and wider uptake of AWM technologies and approaches has not been as successful. We need to learn from successful AWM interventions, those interventions that have led to a sustained or increased uptake of AWM technologies or approaches, and which have led to improved well-being of farmers and livestock keepers in the rural development context of sub-Sahara Africa. This paper explores AWM interventions, specifically, the impacts these interventions have had and the factors contributing to the success of these interventions. In four countries within the Volta and Limpopo river basins, consultations were carried in 33 case studies of successful AWM interventions with implementing organisations and beneficiaries using a participatory GIS methodology. A systematic text analysis of 55 case study reports showed that these 33 interventions have had a positive impact on the well-being of beneficiaries and there was a sustained and wider uptake of the AWM technologies or approaches introduced. A clear demand for the technology, appropriate design of the technology, input support, training and capacity building, and a sense of ownership of the community helped to sustain the uptake of AWM technologies and approaches. We conclude that implementing organisations would benefit from investing in the soft components of an AWM intervention, as this will increase the likelihood of successful adoption and adaptation of the AWM technologies and approaches in the long-term.