The Semi-Arid region of Brazil (SAB) has been periodically affected by moderate to extreme droughts, jeopardizing livelihoods and severely impacting the life standards of millions of family farmers. In the early 1990s the Human Coexistence with Semi-Aridity (HCSA) emerged as a development approach. The debate on HCSA is limited to Brazilian literature but as a technological and a bottom-up governance experience, researches on the topic could add some insights to international debate on living with drought. The present paper adopts an historical perspective on HCSA before discussing the main HCSA’s rainwater-harvesting methods found in two case studies in the SAB as a local appropriate and advanced technological package for achieving Sustainable Development Goals (SDG). Qualitative analysis of 32 semi-structured interviews with key local stakeholders, 29 unstructured interviews with family farmers, and surveys in 499 family farms are used. The results show that regardless the highly adaptive potential, the technologies are adopted in differ rates among them and in between case studies chosen, influenced by non-technological factors and interacting the broader public policies context. Scaling up the HCSA’s technologies in the rural SAB is a development path towards the SDGs.