In response to pressing global challenges like climate change, rapid population growth, and an urgent need for sustainable infrastructure, cities face an immediate and crucial necessity to transition swiftly toward an integrated approach to managing urban water resources. This shift is not merely an option but an imperative, driven by the rapidly evolving urban landscape. In addressing this imperative, a crucial decision support tool that has emerged as an asset in the domain of urban water planning and management is the Urban Water Use (UWU) tool. This tool offers an integrated approach for strategic planning, promoting urban water conservation and environmental health through the investigation of interventions in urban infrastructure under different scenarios. In this study, the latest version of this UWU tool was deployed in a case study conducted in Almirante Tamandaré, Brazil. The objective was to evaluate how an integrated decision-making approach concerning urban water systems influences the efficiency and effectiveness of interventions, ultimately contributing to achieve widespread adoption, accessibility, and relevance of urban water services. The refined UWU tool evaluates a spectrum of measures across diverse scenarios, incorporating various drivers, focusing on the stakeholders' visions for the locality. These visions are composed of sustainability indicators, specifying different sets of target values and importance weights for each indicator. The approach followed in this study demonstrates how the effectiveness indexes can vary based on stakeholders' perception. Measures under Water Sensitive Urban Design and Water Demand Management strategies were deployed to simulate the response of urban water systems under three distinct scenarios, embracing the complexities of social dynamics and of climate change. The findings of the study emphasize that realizing a desired vision through selected measures relies significantly on the adoption of an integrated approach within the decision-making process. The stakeholders' perception of how indicators should be weighted while defining the vision was found to significantly impact the effectiveness range of these measures.