Sustainable water resources management assessment frameworks (SWRM-AF) with associated indicators and benchmarks have appeared widely during the last decades to improve or maintain water resources. Examination or evaluation of their appropriateness and refinement for particular arid and semi-arid regions is a relatively unexplored area. To fill this gap in knowledge, a systematic review of relevant 21st century studies identified within two extensive databases, Scopus and Engineering Village, and in grey literature, is undertaken in this study. Therein, 17 studies are identified and thoroughly explored to identify their focus, application, and framework construction. The results of the comparative analysis among these frameworks show that the average numbers of components and indicators are 4.5 and 17.6, respectively. Meanwhile, categorical rescaling (47.1%), equal weighting (47.1%), arithmetic technique (82.35%), local scale (52.8%), and interval of the final index value of [0–100] (41.2%) are the most commonly used normalization methods and elements. The paper concludes that none of the existing tools reviewed is 100% applicable for arid and semi-arid regions, and therefore the case is made for developing a new bespoke SWRM-AF. The outcomes of this paper provide some useful insights into what should be included therein (e.g., stakeholder engagement and specific indicators to fit the context).