Concentrated Solar Power (CSP) plants rely on efficient cooling systems to maintain thermal efficiency and stable electricity generation. However, conventional wet cooling is highly water-intensive, limiting CSP deployment in arid regions. This review explores innovations in low-water and water-saving strategies, including dry cooling, radiative cooling, and hybrid configurations (series, parallel, series-parallel). Dry cooling can reduce water consumption by up to 94% but typically raises the levelized cost of electricity (LCOE) by about 8-15%. Hybrid systems have shown 50-70% water savings with < 1% LCOE penalty and 2.5-3.2% higher power output, while radiative cooling can cut water use by 40-85% annually and increase annual power generation by 2.4-11%. Combining radiative with dry/wet methods further boosts efficiency with minimal water use. Nanofluid-based wet cooling achieves up to 10.2% better heat transfer and 76% water savings, though issues like sedimentation and stability remain. The review also examines techno-economic trade-offs, noting that dry cooling can raise LCOE by up to 15%, and highlights AI-driven smart controls for adaptive operation. Despite notable advances, challenges such as performance drop at high temperatures, parasitic losses, and high capital cost persist. Future research should target hybrid optimization, affordable materials, and carbon credit incentives to improve viability. These insights underscore the importance of adaptive, water-efficient cooling technologies for sustainable CSP deployment in water-scarce environments. [GRAPHICS]