Water scarcity commonly motivates managed aquifer recharge projects, but other factors can motivate recharge efforts, including in relatively water-rich areas. Surface water quality regulation has been a major driving force behind a large-scale recharge project in development in Virginia’s Coastal Plain region, where nutrient pollution from agricultural and urban sources has degraded the Chesapeake Bay’s ecosystems, leading state and federal regulators to require dischargers to reduce their nutrient contributions to the watershed over time. Hampton Roads Sanitation District is pursuing the Sustainable Water Initiative for Tomorrow, an innovative, multi-benefit initiative designed to address both nutrient pollution in the Chesapeake Bay watershed and regional groundwater overdraft in the Coastal Plain. When fully implemented, the initiative is expected to recharge approximately 100 million gallons per day of drinking-water quality, treated municipal wastewater into the Potomac Aquifer System through injection facilities located at five of the District’s wastewater treatment plants. As a result, the District expects to reduce its nutrient discharges from those plants by approximately 90%, enabling it to meet its own mandated nutrient limits while also generating nutrient credits that it can trade to other dischargers. Modeling suggests that the initiative will increase regional water pressure within the confined aquifer system, helping to combat groundwater overdraft and its negative impacts, including aquifer compaction and related land subsidence, falling water levels in wells, and saltwater intrusion. This case study provides insights into the influence of institutional context on managed aquifer recharge and on multi-benefit water resource projects more generally.