Water is important for human health, industry, agriculture and ensuring the integrity and sustainability of the ecosystem. The water resources are the top affected by climate variability and population growth. The current population of Rwanda is about 12 million heading to about 25 million in 2050 under the changing climate, where since 1970 temperature rose by 1.4°C and is predicted that in 2050 to be about 2.5°C with severe effects on water resources in Rwanda. Thereby, this study reviewed the status and causes of water quality problems and suggested appropriate options to undertake for sustainable water resources access, employ and management in Rwanda. It was noticed that among others, the key threats to water quality in Rwanda, include not limited to climate change causing rainfall patterns which generated flooding, landslides and periodic droughts, which loaded pollutants into water. In addition, water quality is jeopardized by the rapid population growth, agrochemicals, industrialization, urbanization, soil steepness and land mismanagement. Accordingly, the reviewed water quality indicate that the water quality pollution likelihood is increasing over time. These facts reveal that the water quality soon or late will be highly polluted and calls for further adaptation and management measures.