This paper challenges the assumption that low cost CAPEX (capital expenditure) water supply infrastructure provides reduced life cycle costs when compared with higher cost CAPEX investments. The assumption is applied through a comparison of 10 years of financial data (2006–2016) from point source water supplies (accompanied by Emergency Expenditure – EMMEX investments – emergency water trucking, treatment and distribution) and piped water supply systems in two districts of the Ethiopian Central Highland region of Amhara. This study concluded that on average point source water supplies accessing shallow groundwater were non-functional for an average of 60 months in a project period of 10 years. To supplement the water supply demand during the non-functionality period, emergency water trucking and treatment was provided over a 10 year period at a per capita cost of USD 2,257. In comparison, the per capita cost of piped water supplies was USD 65 for a project period of 20 years. The study concluded that piped water supplies are less expensive than point source supplies when CAPEX and emergency water supply provision costs are considered under a life cycle cost analysis.