With >400 small (<1 ha) lakes, the arid Khorezm Province in Uzbekistan may be well-suited for aquaculture production. Developing water resources to provide a local food supply could increase fish consumption while improving the rural economy. Hydroecological (biological and physical) and chemical characteristics (including legacy pesticides ΣDDT and ΣHCH) of four representative drainage lakes in Khorezm from 2006 to 2008 were analyzed for the lakes’ capability to support healthy fish populations. Lake characteristics were categorized as “optimal” (having little or no effect on growth and development), “tolerable” (corresponding to chronic or sub-lethal toxicity) and “lethal” (corresponding to acute toxicity). Results indicate that three lakes are likely well-suited for raising fish species, with water quality meeting World Bank aquaculture guidelines. However, the fourth lake often had salinity concentrations > optimal levels for local fish species. Pesticide concentrations in water of all four lakes were within tolerable aquaculture ranges. Although water ΣDDT concentrations were >optimal limits, results from chemical analysis of fish tissues and semi-permeable membrane devices indicated that study lake ΣDDT concentrations were not accumulating in fish or posing a human health threat. Land and water management to maintain adequate lake water quality are imperative for sustaining fish populations for human consumption.