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Violence over water resources has persisted in various forms for thousands of years, driven by complex ideological, religious, economic, and strategic factors. Scarce and valuable freshwater has played a role in conflicts as a contributing factor, a target or tool, or a weapon. The focus of this review is on specific instances of violence around water and water systems conflict in Syria, Iraq, and Yemen, where water resources and human-built water systems have been both weapons and targets of conflict. A new cycle of violence in the region, growing in extent and severity, began approximately three decades ago and is described here in the context of broader regional water challenges and theoretical issues around environmental security. New data and definitions and an analysis of the types of event and sources of information are also provided in the context of international humanitarian law. This assessment confirms and expands upon previous work that evaluates trends toward the weaponization of water and the targeting of water systems in Middle East conflicts. Initial recommendations for reducing these trends are provided. This article is categorized under: Human Water > Water Governance Human Water > Rights to Water Science of Water > Water Quality