Despite the emphasis of Integrated Water Resources Management (IWRM) on 'soft' demand-side management, large-scale water infrastructure is increasingly being constructed in basins managed under an IWRM framework. While there has been substantial research on IWRM, few scholars have unpacked how IWRM and large-scale water infrastructure development coexist and conflict. Piura, Peru is an important site for understanding how IWRM and capital-intensive, concrete-heavy water infrastructure development articulate in practice. After 70 years of proposals and planning, the Regional Government of Piura began construction of the mega-irrigation project, Proyecto Especial de Irrigacion e Hidroelectrico del Alto Piura (PEIHAP) in 2013. PEIHAP, which will irrigate an additional 19,000 hectares (ha), is being realised in the wake of major reforms in the Chira-Piura River Basin, a pilot basin for the IWRM-inspired 2009 Water Resources Law. We first map the historical trajectory of PEIHAP as it mirrors the shifting political priorities of the Peruvian state. We then draw on interviews with the newly formed River Basin Council, regional government, PEIHAP, and civil society actors to understand why and how these differing water management paradigms coexist. We find that while the 2009 Water Resources Law labels large-scale irrigation infrastructure as an 'exceptional measure', this development continues to eclipse IWRM provisions of the new law. This uneasy coexistence reflects the parallel desires of the state to imbue water policy reform with international credibility via IWRM while also furthering economic development goals via large-scale water infrastructure. While the participatory mechanisms and expertise of IWRM-inspired river basin councils have not been brought to bear on the approval and construction of PEIHAP, these institutions will play a crucial role in managing the myriad resource and social conflicts that are likely to result.