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Since the 1990s, water has been a main area of conflict within the neoliberal policy paradigm. Indeed, the neoliberal era has been marked by a substantial number of struggles over the municipalization of the service across the Global South. However, the development of the public enterprises that have emerged from this process has been less studied. This article focuses on the case of the water service in La Paz, Bolivia, where a contract with a French consortium expired in 2007, and where the water shortages that affected the city in 2016–2017 are inscribed in the specific context of state reform. Indeed, Bolivia was the backdrop for the “Water Wars” that led to deep political changes in the country, with the electoral victory of Evo Morales in 2005, whose political program was based on the re-appropriation of natural resources and the introduction of various reform policies. The water crisis revealed tensions between a centralizing approach and the autonomous social organizations that brought the current president to power, as well as between different levels of government, for example national and municipal bodies, residential committees, and international NGOs. Thus, the objective of the analysis presented in this paper is to understand the transition from a water crisis to a political crisis. As such, the paper contributes to the sociology of public policies based on an examination of the “division of state labor” and struggles for state power. The paper finds that the main actors of the crisis reveal a renewed focus on the technical aspects of state engineering, which tend to present an obstacle to the implementation of ecological alternatives.