This scoping study offers implementable recommendations for investment opportunities in multiple use water services in Ghana. The report is based on an assessment of existing MUS modalities and innovations, potential for implementation and possible barriers. The study shows that MUS is a de facto practice both in formal domestic and irrigation service delivery, complemented by self-supply initiatives. Moving from de facto multiple use practices to a more planned and structured MUS approach can be done from various entry-points. Based on risk assessments, this study concludes that domestic-plus, rehabilitation of small reservoirs and self-supply for irrigation present the best direct investment opportunities for maximum impact.