Water scarcity affects people all over the planet but it is particularly disastrous to the extremely poor people most of whom live on a subsistence basis in Sub-Saharan Africa (SSA). Climate change will not only increase scarcity and make it harder for people in SAA to produce food, it is also projected to bring along an increasing share of natural disasters. Lester R. Brown has been one of the most influential sources of the argument that water is so scarce that it is running out many places. If that is true, how will the extremely poor cope and can development aid prevent water scarcity from exacerbating extreme poverty and its many security related consequences? To investigate that further this paper will look specifically at: the impacts of water scarcity on the prospects for poverty alleviation, and the role of development aid in this. It is difficult to show how much water scarcity affects poverty alleviation and even harder to determine what role development aid plays in all of this because it is all a matter of degree, which again is dependant on the readers point of view on what is acceptable and what is not. Yet there seems to be a lack of awareness as to just how essential water scarcity is. Water scarcity is commonly at the core of security issues such as diseases, conflicts, slums, and perhaps most importantly hindering the production of food and thereby development. In order to explain these connections this paper has had to go back and re-evaluate the essential theoretical concept of how poverty alleviation is achieved, especially focusing on the good and bad effects development aid. It has found that there continues to be an excessive focus on the production of economic growth, which does not take into account that a western-lifestyle and financial structure is far less important than surviving and being able to drink clean water and eat somewhat nutritional food. An examination of the level of water scarcity has found that although a physical scarcity exist in many poor countries most of SAA actually has good water supplies them problem is simply that they do not have the economic means to access the resources i.e. make wells and irrigation systems. Yet, despite of the 1.1 million with no access to clean water and the 2.6 millions with no access to basic sanitation most development aid institutions do not make water scarcity a priority in their budgets nor in their overall development goals such as the Millennium Development Goals where only a mention of water and sanitation occurs in section 7.c. this is not enough and ICCP projections along with those of Brown are well within their reason to sound the alarm if only they were taken sufficiently serious. Another point made though this paper is that it is, now, more than ever, in the interest of all actors to prevent the escalation of extreme poverty that water scarcity causes. Immigration, epidemics, global warming disasters, conflicts in addition to food and water scarcity are much more expensive consequences than it is to make a more serious effort to address the issue of water scarcity and extreme poverty alleviation.