India categorizes the water situation of more than one-quarter of its governmental units as over-exploited, critical, or semi-critical. Unsustainable water extraction, inefficient use of resources, and the large water demand of the agricultural sector (more than 90%) are among the causes of the worsening state of water resources. In order to assure the access to clean drinking water, the Indian Ministry of Drinking Water and Sanitation initiated the National Rural Drinking Water Security Pilot Project in 2011. To analyze the costs and benefits of this pilot project, we follow the pretest–posttest control group study design comparing two points in time and two groups (study group and control group). In total, 12 sample villages (consisting of 3,265 households and 20,767 individuals) in two different areas were included. Costs and benefits were captured if they were directly and causally linked with the project. This includes financial and economic costs for individuals and the government, as well as benefits in four major fields: health, economy, environment, and time savings. We found total benefits ranging between USD 420,000 in low performing sites and USD 480,000 in high performing sites. Corresponding costs were between USD 40,000 and 45,000. Adjusted to per capita values, benefits vary between USD 54 and USD 300 and costs between USD 5 and USD 28. Adjusting a 99% confidence interval, the net benefits will vary between approximately USD 150 and USD 400 in the high performing sites and between USD 30 and USD 70 in the low performing sites. The expected benefit-to-cost ratios are 11 in high performing sites and 10 in the low performing sites. Due to the large social return in high as well as in low performing study sites, this paper recommends prolonging and upscaling the interventions evaluated in the pilot project sites.