Management and control of surface waters, especially in low rainfall areas, is one of the ways to supply water to meet the needs of residents of dry and water-scarce regions of Iran. Khosf County, located in South Khorasan Province, is one of the areas where residents have long been attempting to manage and control surface waters due to water scarcity. In this regard, by creating water structures such as dams and reservoirs, they have tried to control and utilize surface waters resulting from rainfall. A descriptive-analytical method was used to conduct this research. Data collection and organization were based on field and library studies in Khosf County, and some of these structures were identified and their distribution analyzed using GIS software. The main goal of this research is to investigate and analyze the traditional and ancient methods of controlling and managing surface waters and the role of some related structures such as dams and reservoirs in Khosf County. The results of this research indicate that the highest priority in establishing and distributing these structures is proximity to surface water sources (16% for reservoirs and 15% for dams) and then suitable elevation (8% for reservoirs and 10% for dams) for better access to surface waters. Additionally, residents of this area have attempted to control and manage the flow speed of surface waters to enter the dams and reservoirs, considering the slope and suitable direction of the slope. The outcome of these actions has resulted in changes in the region's landscape and mitigating harsh environmental conditions for the continued livelihood of residents.