Pressure tunnels and pressure shafts are essential components of storage hydropower schemes. Their design necessitates expertise in hydraulic, structural and geotechnical engineering. Accurately modeling the lining-rock system involves accounting for hydraulic-mechanical interactions. This book presents a thorough examination of the design of pressure tunnels and pressure shafts for internal and external water pressures. It addresses the configuration of waterway systems, alignment selection, and types of linings, including considerations related to trends in pumped storage hydropower development. The book discusses characteristics of pervious linings and their implications for design, offers an overview of design methodologies and criteria, and includes a chapter on rock hydraulics, a subject not frequently covered in detail elsewhere. Analytical methods are provided for designing linings, such as reinforced, non-reinforced, passively prestressed concrete linings, and steel liners. The determination of stresses, deformations, and water losses, if any, considers also potential orthotropic mechanical and hydraulic properties of the rock mass as well as grouted or loosened rock zones. Special attention is given to the first filling of waterway systems being often the critical load case. This is the first comprehensive book in English which covers state-of-the-art design and calculation methods with case studies. It is essential for hydropower and energy project engineers, and graduate students interested in learning more on this topic.