The book largely focuses on the history of two federal agencies, the Bureau of Reclamation and the U.S. Army Corps of Engineers, and their struggles to remake the American West in ways to satisfy national settlement and energy generation goals.

The book concludes that the development-driven policies, formed when settling the West was the country's main concern, have had serious long-term negative effects on the environment and water quantity.

The book was again reissued in 2017, with a lengthy Postscript by Lawrie Mott, a former staff scientist at the Natural Resources Defense Council.

[1] In a review written shortly after publication, The New York Times described the book as "a revealing, absorbing, often amusing and alarming report on where billions of their dollars have gone – and where a lot more are going.

[6] A four-part television documentary based on the revised book was produced in 1996 by KTEH, the PBS affiliate in San Jose, California.