As the world population grows, there is a pressing need to improve productivity from water use in irrigated and rain-fed agriculture. Foliar diseases have been reported to decrease crop water-use efficiency (WUE) substantially, yet the effects of plant pathogens are seldom considered when methods to improve WUE are debated. We review the effects of foliar pathogens on plant water relations and the consequences for WUE. The effects reported vary between host and pathogen species and between host genotypes. Some general patterns emerge however. Higher fungi and oomycetes cause physical disruption to the cuticle and stomata, and also cause impairment of stomatal closing in the dark. Higher fungi and viruses are associated with impairment of stomatal opening in the light. A number of toxins produced by bacteria and higher fungi have been identified that impair stomatal function. Deleterious effects are not limited to compatible plant–pathogen interactions. Resistant and non-host interactions have been shown to result in stomatal impairment in light and dark conditions. Mitigation of these effects through selection of favourable resistance responses could be an important breeding target in the future. The challenges for researchers are to understand how the effects reported from work under controlled conditions translate to crops in the field, and to elucidate underlying mechanisms.