Research on the hydrogeology of andesitic volcanic aquifers in subduction areas is reviewed. Andesitic aquifers are of high interest in volcanic arc islands and subduction zones, where they constitute a strategic water resource. This review gathers a compilation of worldwide results and case studies to propose a generic hydrogeological conceptual model (GHCM). It is based on the geological conceptual model splitting the volcanic edifice, from upstream to downstream, into central, proximal, medial and distal zones. In this geological structure, the GHCM identifies where the main aquifer types (fractured lava, pyroclastic flows, and the volcano-sedimentary basins downstream) and the typical aquitards (lahars, fine pyroclastic falls and surges, indurated pyroclastic flow, and weathered rocks) are structured and organized. To integrate the evolution of volcanoes and some specific volcanic activities, a specific GHCM for old andesitic volcanoes or andesitic shield volcanoes is detailed. The paper also describes how the GHCM results are of use to hydrogeologists in terms of scale (from the lithological units to the regional scale), to effectively site water wells, and to sustainably manage groundwater resources in such aquifers. Among these various scales, the volcanic “flank continuum” is presented as the most adapted to support groundwater resources management. Several ways to improve this GHCM are suggested, notably to better consider the geological complexity of these aquifers.