The basic objective of the irrigation reforms, i.e., participatory irrigation management in Pakistan, was a better economic and financial management of irrigation service delivery, equity in water distribution, and better environmental outcome. The aim of this study was to assess the optimism with the reforms package that has actually delivered expected outcomes. For this purpose, this study used a cross-sectional dataset of 567 farmers in five selected Area Water Boards (AWBs) of Punjab and Sindh provinces of Pakistan. Important institutional features including compliance, adaptiveness, clarity of objectives, good interaction, and appropriate scale, were modeled through structural equation modeling on the overall performance assessment of water use associations from a farmer’s perspective. Results suggested that clear objectives, adaptiveness, scale, and compliance show a strong relationship with an overall assessment of performance. While good interaction has not impacted significantly with an overall performance assessment. The impact of institutional feature on the overall performance assessment depends on the nature of performance considered, e.g., drivers of the economic performance of a farmer organization may not be the same as the drivers of its environmental performance. Besides offering insights on specific drivers that matter for a particular dimension of the institutional performance of farmer organizations, the study suggests that participatory irrigation management institutions are still in infancy even after decades of their introduction, and just creating institutions is neither mandatory nor sufficient. Furthermore, the institutional designs are considered critical for the success of participatory institutions. Therefore, there is a need to consider the conformity of the strategies with the existing norms and compliance to the on-going procedures.