A decline in water availability due to rising temperatures and growing water demand presents significant and unique challenges to agricultural producers in Uzbekistan. This study investigates the impact of climate change on farm revenues and water use efficiencies in Western Uzbekistan. A spatially explicit stochastic optimization model is used to analyze crop and water allocation decisions under conditions of uncertainty for irrigation water availability in the area for the first time. Results show farmers' income could fall by as much as 25% with a 3.2 °C temperature increase and a 15% decline in irrigation. Farmers located in the tail end of the irrigation system could lose an even greater share of their revenues. A more conservative increase in temperature could increase farmer income by as much as 46% with a 2.2° temperature increase and only 8% decline in irrigation water since some crops benefit from extended vegetation periods. Under both pessimistic and optimistic scenarios, environmental challenges due to shallow groundwater tables may improve associated with enhanced water use efficiency.