In many areas of southern Europe, the scarcity of water due to climate change will increase, making its availability for irrigation an even more limiting factor for agriculture. One of the main necessary measures of adaptation of the vineyards in these areas will be the implementation of water-saving irrigation strategies and technologies to improve WUE (water use efficiency). The objective of the present study was to evaluate the long-term economic viability/profitability of different deficit irrigation techniques such as regulated deficit irrigation (RDI) and partial root-zone irrigation (PRI) with low water volume/fertilizer applied in a Monastrell vineyard in southeastern Spain to plants grafted on different rootstocks, and to assess the productive, social, and economic efficiency in these semiarid conditions. Through a cost/benefit analysis, socio-economic and environmental criteria for the selection of optimal deficit irrigation strategies and tolerant/water use efficient rootstocks for the vineyards in arid environments are proposed. Our analysis shows a clear conflict between productivity and quality in wine grape production. Productive and economic indices, such as yield, productive WUE (kg m⁻³), economic efficiency (€ m⁻³), break-even point (kg ha⁻¹), and water productivity (€ m⁻³), were inversely related with berry quality. Besides, high berry quality was closely related with higher production costs. Under the current market of low-priced grapes, if the grower is not rewarded for the quality of the grapes (considering technological, phenolic, and nutraceutical quality), the productivity vision will continue and the cost-effective option will be to produce a lot of grapes, even if at the expense of the berry and wine quality. In this situation, it will be difficult to implement optimized deficit irrigation strategies and sustainable irrigation water use, and the pressure on water resources will increase in semiarid areas. Public policies should encourage vine growers to invest in producing high-quality grapes as a differentiating character, as well as to develop agronomic practices that are environmentally and socially sustainable, by the grapes more adjusted to their real quality and production costs. Only in this way we can implement agronomic measures such as optimized low-input DI (deficit irrigation) techniques and the use of efficient rootstocks to improve WUE and grape quality in semiarid regions in a context of climate change and water-limiting conditions.