Abiotic stress significantly limits plant growth and production. Drought, in particular, is a severe constraint that affects growth and limits agricultural productivity on a global scale. Water stress induces in plants a set of morpho-anatomical (modification of root and leaf structure), physiological, and biochemical (relative water content, membrane stability, photosynthesis, hormonal balance, antioxidant systems, and osmolyte accumulation) changes mainly employed to cope with the drought stress. These strategies allow the plant to overcome the unfavorable period of limited water availability. Currently, a promising alternative is available to improve plant growth and tolerance under drought conditions. The use of osmotolerant plant growth-promoting rhizobacteria (PGPR) as inoculants can alleviate water stress by increasing the water use efficiency of the plant. The PGPR improve the tolerance of plants to drought, through changes in the morphology and architecture of the root system, production of phytohormones, extracellular polysaccharides, ACC 1-(aminocyclopropane-1-carboxylate) deaminase, volatile chemicals, and osmolyte accumulation. They may also enhance the antioxidant defense system and induce transcriptional regulation of stress response genes. This review addresses the effects of stress on plant growth, adaptation, and response to drought conditions and discusses the significant potential of PGPR to modulate the physiological response against water scarcity, ensuring plant survival and improving the resistance and growth of agricultural crops.