Water-cooled lithium-lead breeding blanket is considered a candidate option for European DEMO nuclear fusion reactor. ENEA and the linked third parties have proposed and are developing a multi-module blanket segment concept based on DEMO 2015 specifications. The layout of the module is based on horizontal (i.e. radial-toroidal) water-cooling tubes in the breeding zone, and on lithium lead flowing in radial-poloidal direction. This design choice is driven by the rationale to have a modular design, where a basic geometry is repeated along the poloidal direction. The modules are connected with a back supporting structure, designed to withstand thermal and mechanical loads due to normal operation and selected postulated accidents. Water and lithium lead manifolds are designed and integrated with a consistent primary heat transport system, based on a reliable pressurized water reactor operating experience, and the lithium lead system. Rationale and features of current status of water-cooled lithium-lead breeding blanket design are discussed and supported by thermo-mechanics, thermo-hydraulics and neutronics analyses. Open issues and areas of research and development needs are finally pointed out.