As blue water resources become increasingly scarce with more frequent droughts and overuse, irrigated agriculture faces significant challenges to reduce its water footprint while maintaining high levels of crop production. Building soil health has been touted as an important means of enhancing the resilience of agroecosystems to drought, mainly with a focus in rainfed systems reliant on green water through increases in infiltration and soil water storage. Yet, green water often contributes only a small fraction of the total crop water budget in irrigated agricultural regions. To scope the potential for how soil health management could impact water resources in irrigated systems, we review how soil health affects soil water flows, plant–soil–microbe interactions, and plant water capture and productive use. We assess how these effects could interact with irrigation management to help make green and blue water use more sustainable. We show how soil health management could (1) optimize green water availability (e.g., by increasing infiltration and soil water storage), (2) maximize productive water flows (e.g., by reducing evaporation and supporting crop growth), and (3) reduce blue water withdrawals (e.g., by minimizing the impacts of water stress on crop productivity). Quantifying the potential of soil health to improve water resource management will require research that focuses on outcomes for green and blue water provisioning and crop production under different irrigation and crop management strategies. Such information could be used to improve and parameterize finer scale crop, soil, and hydraulic models, which in turn must be linked with larger scale hydrologic models to address critical water-resources management questions at watershed or regional scales. While integrated soil health-water management strategies have considerable potential to conserve water—especially compared to irrigation technologies that enhance field-level water use efficiency but often increase regional water use—transitions to these strategies will depend on more than technical understanding and must include addressing interrelated structural and institutional barriers. By scoping a range of ways enhancing soil health could improve resilience to water limitations and identifying key research directions, we inform research and policy priorities aimed at adapting irrigated agriculture to an increasingly challenging future.