In Sierra Nevada (southern Spain), the highest mountain range in southern Europe, the application of an ancestral Integrated Water Resources Management system (IWRM), based on the conjunctive use of groundwater and surface water, provides water resources for irrigation and supply in the driest months of the year in this semiarid mountain region. Meltwater is derived from the headwaters of the mountain streams and rivers through a set of uncoated channels excavated in the ground (locally known as acequias de careo) to infiltrate at the upper part of the valleys. Water infiltrated along the acequias de careo slowly flows down the hillsides, through the weathered zone of the hard rock aquifer and the glacial and periglacial sediments. The recharge accomplished through this Managed Aquifer Recharge technique (MAR) activates numerous springs located halfway down the hillside and increases the base flow of the rivers. In this study, focused on a careo channel located on the southern slope of Sierra Nevada called Acequia de El Espino, different archaeological, sedimentological, geophysical and hydrogeological techniques are applied to determine the age and the efficiency of this ancestral example of a MAR and IWRM system. Results suggest that the acequias de careo may be the oldest MAR system in Europe, and that this MAR technique could be applied in other high mountain alpine watersheds to mitigate the effects of climate change.