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If the holder uses a damage-dealing Water-type move, then the holder consumes this item and the power of that move is increased by 50%. One-time use.
In single battles, Water Gem is not typically a useful item, unfortunately. While the one-time boost to Water-type attacks is nice, most Pokemon using Water-type attacks would rather have the more reliable power of Life Orb or Choice items.
Typically Gems are more valuable in the VGC and similar environments, and Water Gem is often used here to boost the power of Water-type attacks such as Hydro Pump from Pokemon such as Rotom-W or Vaporeon. The one-time power boost can come in very useful in such a fast-paced metagame, especially as it comes without any drawbacks. In addition, it can be used to increase the power of Surf and other common spread-damage attacks.
Occur randomly in Dust Clouds.