The increasing risk of water deficit stress due to global warming subjects winegrowers of traditional rain fed viticulture regions to new challenges regarding vine water status assessment and possible drought mitigation strategies, such as irrigation. This review summarizes the most recent studies on the impact of water deficit stress on vine and berry physiology; it discusses the latest scientific advances regarding hormonal and hydraulic regulation and segmentation and addresses the current debate on iso/an-isohydricity within vine cultivars. Latest literature on irrigation frequency, water stress memory and the impact of abiotic factors such as VPD (Vapor Pressure Deficit), radiation, temperature and canopy architecture on vine physiology and water use, raise important questions on water status assessment and the implementation of irrigation strategies. Practical consequences regarding the effects of vine water regime on vine water regulatory mechanisms are discussed. Recent technical and scientific advances shed new light on how site specific irrigation strategies matching production objectives could improve vineyard water use.