Electric power is required to produce, treat, distribute, and recycle water while water is required to generate and consume electricity. Naturally, this energy-water nexus is most evident in multi-utilities that provide electricity and water but still exists when the nexus has distinct organizations as owners and operators. Therefore, the sustainability question that arises from energy-water trade-offs and synergies is very much tied to the potential for economies of scope. Furthermore, in the Middle East and North Africa (MENA) region, multi-utilities are not only common, but also the nexus is particularly exacerbated by the high energy intensity of the water supply due to limited fresh water resources. The goal of this paper is to identify and motivate several opportunities for enhanced integrated operations management and planning in the energy-water nexus in multi-utilities in the MENA. It proceeds in four parts. First, an exposition of the energy-water nexus especially as it applies to the MENA is given. This discussion focuses on the electric power system, the potable water distribution system, and thirdly, the wastewater distribution system. Second, the paper shifts to opportunities in integrated operations management highlighted by an energy-water nexus supply-side economic dispatch illustration. Thirdly, the discussion shifts to planning opportunities for the energy-water nexus for the sustainable development of water and energy resources. A concluding section summarizes the policy implications of the identified opportunities. Opportunities for energy-water nexus management in the MENA 2 In the MENA region, this nexus is particularly exacerbated. As shown in Figure 1, per capita demand for electricity has steadily increased in most MENA countries. Those countries that have seen recent per capita reductions (e.g. Kuwait, UAE, and Bahrain) are three of the four most electricity intensive countries in the region. Meanwhile, Figure 2 shows that all MENA regions are unsustainably consuming water and drawing down their total renewable water resources per capita. These trends are further exacerbated by the high energy intensity of the water due to the limited freshwater resources and the hot and arid climate. As shown in Table 1, energy-expensive groundwater and desalination contribute 65% and 5% of the total water supply in the MENA respectively (FAO, 2012). Four out of the six Gulf Cooperation Council (GCC) countries (Saudi Arabia, UAE, Kuwait, Qatar) are among the ten countries with the highest desalination capacity, representing between them nearly 40% of global desalination capacity (Mezher et al., 2011). Despite this exacerbated relationship, the norm in electricity and water utilities is for siloed operations associated with the discipline of each product. This paper, instead, discusses several opportunities for enhanced integration of operations and planning of the energy-water nexus from a multi-utility perspective. While not all MENA regions have electricity-water multi-utilities, their presence does ...