Sustainable water resource management in arid regions is critical for ensuring long-term water security, especially in a country like India where climatic variability, rapid population growth, and intensive agricultural practices place severe pressure on limited water resources. Arid and semi-arid regions such as Rajasthan, parts of Karnataka, Telangana, and western India face acute water scarcity due to low precipitation, high evaporation rates, groundwater over-extraction, and declining surface water availability. Groundwater depletion, deteriorating water quality, institutional fragmentation, and inadequate infrastructure further complicate effective management. Climate change has intensified extreme events such as droughts and floods, disrupting hydrological cycles and reducing the reliability of traditional water systems. Sustainable solutions therefore require integrated approaches such as demand management, improved irrigation efficiency, artificial groundwater recharge, rainwater harvesting, conjunctive use of surface and groundwater, and nature-based solutions for ecosystem restoration. Community-led initiatives, technological interventions, and policy frameworks such as Integrated Water Resources Management (IWRM) offer promising pathways for enhancing resilience. Case studies from Rajasthan, Karnataka, Telangana, and western India demonstrate that coordinated planning, decentralised governance, and scientific monitoring can significantly improve water availability. Strengthening institutions, expanding infrastructure, and adopting climate-adaptive strategies remain essential for achieving sustainable water management in India’s arid regions.