Water management plays a vital role in the sustainable cultivation of cotton (Gossypium hirsutum L.), a globally significant cash crop. Effective irrigation practices are essential to enhance water use efficiency (WUE), optimize yield and maintain fiber quality amid challenges like declining water resources and changing climatic conditions. This review critically examines various irrigation methods, including surface irrigation, drip irrigation (surface and subsurface) and advanced systems like Low-Energy Precision Application (LEPA), Low-Elevation Spray Application (LESA) and Mobile Drip Irrigation (MDI). Modernized methods, particularly subsurface drip irrigation, have proven the most efficient in conserving water and increasing yields by minimizing soil evaporation and ensuring precise water delivery to the root zone. Additionally, the role of irrigation models such as AquaCrop, EPIC, Cotton2K and CROPGRO-Cotton, is discussed in relation to their ability to simulate crop growth and optimize irrigation schedules based on local conditions. The review highlights the importance of understanding crop coefficients (Kc), evapotranspiration and region-specific water requirements in tailoring irrigation strategies. Future outlooks emphasize the integration of advanced irrigation technologies with precision farming to enhance WUE and promote sustainable cotton production. By focusing on localized solutions and fostering the adoption of modern irrigation systems, farmers can address water scarcity challenges while achieving better yields and fiber quality, ensuring long-term economic and environmental sustainability.