The performance of a water distribution system of providing a required flow rate at all the nodes with required pressure heads throughout its design life is affected by uncertainties associated with different parameters such as future water demands, pipe roughness coefficient values, required pressure heads at nodes, etc. The objective of this paper is to present a comprehensive review on the nature of uncertainties (random or fuzzy), various models and methods used for their quantification, and different ways of handling them in the design of water distribution networks. While probabilistic based approaches are used for handling uncertainty of random type, the possibilistic based approach considers uncertainty of fuzzy nature. Some key issues and serious limitations of the existing approaches for modeling uncertain parameters related to water distribution networks are identified. The uncertainty in water demands is due to both their random nature and lack of information about their values. Therefore, a combination of both types of approaches, called the fuzzy random approach, is found to be more effective. The fuzzy random approach can provide optimal design solutions that are not only cost-effective but also has higher reliability to cope with severe future uncertainties.