This study aimed to examine the efficacy and cost of two water delivery systems—water dispensers with cups and water coolers with cups—in increasing students’ lunchtime intake of water in lower-income middle schools. Twelve middle schools in the San Francisco Bay Area participated in a cluster randomized control trial in which they were assigned to one of two cafeteria water delivery systems and received six weeks of promotional activities and water cups or served as a control with no intervention and only traditional water fountains. Students completed surveys about their lunchtime beverage intake and observational data were collected. There was a significant increase in the odds of students drinking water in schools with promotions, cups, and water dispensers compared with control schools with traditional drinking fountains. The average cost of dispenser and water cooler programs was similar, at approximately $0.04 per student per day over a 5-year period. This study suggests that providing water in small dispensers with cups may be a feasible, low-cost option for schools that can increase students’ water intake at lunchtime.