The pressing problems of water scarcity in many parts of the planet make water desalination one of the technological solutions for guaranteeing the fresh water supply. However, desalination processes require high energy consumption, mainly provided by fossil fuels. The integration of renewable energy sources into desalination processes is a promising option for decarbonizing the desalination sector. As most water-scarce regions with access to seawater frequently have high solar irradiation levels, it seems appropriate to exploit the sun to power the desalination process. This work presents the assessment of two integrated solar power and desalination systems regarding efficiency and water production. Two desalination processes (multi-effect distillation and reverse osmosis) are studied for potential coupling with the combined cycle of a central receiver solar plant to produce electricity and freshwater. In the case of the multi-effect distillation plant, it is integrated by replacing the Rankine cycle condenser of the combined cycle. In the case of the reverse osmosis plant, it is powered by the electricity generated from the combined cycle. For this comparison, the 21st of March has been considered as the design point and Almería (in the Southeast of Spain) as the plant location. The results show that the thermal cogeneration option renders a worse outcome (thermal efficiency of 50.2% for LT-MED case) than the decoupled generation of electricity and water (thermal efficiency of 53.3% for RO case), producing 18% less fresh water than the RO configuration (3831 m3/d vs. 4640 m3/d), due to the 6% penalty in the efficiency of the Rankine power cycle in the MED configuration as a result of increasing the condensation temperature from 42.6 °C to 70 °C.