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The results of long-term environmental monitoring of small rivers in the Caucasian Mineral Waters resorts region are presented. The characteristics of the surface water and groundwater at the resorts are considered. The degree and nature of their pollution were evaluated, and the main causes of water pollution in the region—including heavy-metal compounds, petroleum products, and nitrogen-containing compounds—were identified and analyzed. Data on mineral water from a number of production wells that are not compliant with the requirements of GOST R 54316-2011 are given. The analysis of hydrogeodynamic and hydrogeochemical regimes of exploitation of the Kislovodskoye field, recommendations for improving the quality indicators of the main source of the “Narzan” field are given.