The neoliberalisation of water constitutes an emblematic illustration of the enduring encroachment of neoliberalism upon nature. Previous studies in Latin America have examined the transition from Keynesian water utilities to the neoliberal provisions of water services, but paid less attention to the adaptability of the state apparatus and the systematic adjustments required to sustain neoliberalising strategies. Addressing this gap in the literature, this paper examines two decades of change in the public water services of Lima, Peru, as one of the Latin American countries where neoliberal reforms have been more comprehensive and resilient. The analysis focuses on the water policies advanced by the national state and with the reconfiguration of the state apparatus as a result of extra-economic factors. The neoliberalisation of water may have improved the situation at the aggregate level, but inequalities, scarcities and vulnerabilities have been maintained and even reinforced. The achievements and failures of the neoliberalisation of water have ultimately depended on a range of politico-economic and socioecological interactions creatively mediated by the state apparatus. In the end, however, the neoliberal adjustments in the structure and operation of the state have replicated the double exploitation of nature and society that has long shaped Peruvian economic history.