Despite technical advances, traditional large diameter hand-dug wells remain very important in remote and rural communities as a method for gaining access to groundwater for drinking, domestic and agricultural activities. This paper explores and discusses large diameter hand-dug wells in South Africa, with regard to their utilisation, research and development, and the legislative and policy framework guiding their development and use. While large diameter hand-dug wells have featured in national legislative and policy frameworks, and in early technical guidelines, in recent years the subject has not received much attention. There is also little evidence to suggest that large diameter hand-dug wells receive any attention in typical academic and research curriculums. While South Africa's national vision is to provide improved water supply schemes in rural areas under which clean drinking water can be accessed via communal water taps, it is clear that in some rural communities household large diameter hand-dug wells still remain the most feasible and convenient way to provide water, not only for drinking but also for agricultural activities – a key form of livelihood support contributing to poverty reduction. Large diameter hand-dug wells still need attention in the policy arena to improve technical guidance to optimise the development, utilisation and management of these wells.