Past discussions around water-resources management and development in the River Nile basin disregard groundwater resources from the equation. There is an increasing interest around factoring the groundwater resources as an integral part
of the Nile Basin water resources. This is hampered by knowledge gap regarding the groundwater resources dynamics (recharge, storage, flow, quality, surface-water/groundwater interaction) at basin scale. This report provides a comprehensive analysis of the state of surface-water/groundwater interaction from
the headwater to the Nile Delta region. Piezometric and isotopic(δ18O,δ2H) evidence reveal that the Nile changes from a gaining stream in the headwater regions to mostly a loosing stream in the arid lowlands of Sudan and Egypt. Specific zones of Nile water leakage to the adjacent aquifers is mapped using the two sources
of evidence. Up to 50% of the surface-water flow in the equatorial region of the Nile comes from groundwater as base flow. The evidence also shows that the natural direction and rate of surface-water/groundwater interaction is largely perturbed by human activities (diversion, dam construction) particularly downstream of he Aswan High Dam in Egypt. The decrease in discharge of the Nile River along its course is attributed to leakage to the aquifers as well as to evaporative water loss from the river channel. The surface-water/groundwater interaction occurring along the Nile
River and its sensitivity to infrastructure development calls for management strategies that account groundwater as an integral part of the Nile Basin resources.