Pressure Reducing Valves (PRV) have been widely used as a device to control pressure at nodes in water distribution networks and thus reduce leakages. However, an energy dissipation takes place during PRV operation. Thus, micro-hydropower turbines and, more precisely, Pump As Turbines (PAT) could be used as both leakage control and energy generating devices, thus contributing to a more sustainable water supply network. Studies providing clear guidelines for the determination of the most cost-effective device (PRV or PAT) analysing a wide database and considering all the costs involved, the water saving and the eventual power generation, have not been carried out to date. A model to determine the most cost-effective device has been developed, taking into account the Net Present Value (NPV). The model has been applied to two case studies: A database with 156 PRVs sites located in the UK; and a rural water supply network in Ireland with three PRVs. The application of the model showed that although the investment cost associated to the PRV installation is lower in the majority of cases, the NPV over the lifespan of the PAT is higher than the NPV associated with the PRV operation. Furthermore, the ratio between the NPV and the water saved over the lifespan of the PAT/PRV also offered higher values (from 6% to 29%) for the PAT installation, making PATs a more cost-effective and more sustainable means of pressure control in water distribution networks. Finally, the development of less expensive turbines and/or PATs adapted to work under different flow-head conditions will tip the balance toward the installation of these devices even further.