Groundwater extraction in most Middle East and North Africa (MENA) countries far exceeds its renewability, which ranges from 6% to 100%. Freshwater resources to support food production are very limited in this region. Future climate predictions include more consistent and longer wet periods with increasing surplus rainfall, which will enhance flood and flash flood occurrences in the MENA. Demand management of groundwater resources and managed aquifer recharge (MAR, also called groundwater replenishment, water banking, and artificial recharge, is the purposeful recharge of water to aquifers for subsequent recovery or environmental benefits) represent essential strategies to overcome the challenges associated with groundwater depletion and climate change impacts. Such strategies would enable the development of groundwater resources in the MENA region by minimizing the stress placed on these resources, as well as reducing deterioration in groundwater quality. Groundwater augmentation through recharge dams is a common practice in different countries around the globe. Most dams in the MENA region were built to enhance groundwater recharge, and even the few protection dams also act as recharge dams in one way or another. However, the operating systems of these dams are mostly dependent on the natural infiltration of the accumulated water in the reservoir area, with limited application of MAR. This review presents analyses of groundwater renewability and the effectiveness of recharge dams on groundwater recharge, as well as the potential of MAR technology. This study indicates that the recharge efficiency of dam’s ranges between 15 to 47% and is clustered more around the lower limit. Efficiency is reduced by the clogging of the reservoir bed with fine materials. Therefore, there is a need to improve the operation of dams using MAR technology.