In Balochistan groundwater is major source of irrigation, because of the shortage of substitute sources of irrigation. Karezes are the most effective, efficient, and economic sources for irrigation in nature which are diminishing due to increasing pumping amid large number of tubewells. This study aims to find the causes of Karez system decline, constraints, and opportunities in Karez irrigation system rehabilitation. It also aims to assess quity difference between Karez and tubewell in terms of access of communities to water. Focus group discussions was held in both villages of district Pishin, Khushab and Malikyar. This study uses the economic approach of Gini coefficient and Lorenz curve to measure the equity between the Karez and tubewell water distribution. This study concludes that Karezes are more equitable than tubewells in terms of access to water. However, they have not remained any more efficient, economic, and effective, sources of water for irrigation than tubewells due to decline in Karez water amid mass installation of tubewells and exploitation of groundwater. Moreover, climate changes in the shape of less precipitation, rising temperatures, evapotranspiration, and other factors such as population growth and urbanization have further aggravated the situation. This study recommends the dams construction, harvesting of low delta crops, use of modern irrigation approaches, on farm water management, regularization of groundwater pumping through tubewells.