This paper presents the pico-hydro development status in Lao PDR and introduces the Pump as Turbine (PAT) concept as an alternative for isolated communities (40–500 people). The intention is to provide a long-term reproducible system for communities where pico-hydro propeller turbines are insufficient and proper turbines are expensive. This approach presents a high quality and cost-effective solution for rural electrification which can be installed, commissioned, and maintained by local staff and villagers. Furthermore, a 2kWel PAT-scheme is proposed for a community in the Xiagnabouli province and considers power generation alternatives, sizing, asynchronous motor simulation, civil works, cost estimation, and social aspects.