The arid and semi-arid regions within China host 75% of the country's cultivated lands. These regions heavily rely on groundwater for drinking, irrigation, industry and energy production. Understanding recharge and discharge processes is critical to managing sustainable use and development of groundwater resources. Recently, groundwater recharge and discharge have been altered by climate change (air temperature, rainfall) and human activities (e.g. irrigation, pumping, reforestation), resulting in significant changes in the quantity, quality, and spatiotemporal distribution of groundwater resources. This essay describes some examples of the associated issues, challenges and opportunities in the arid and semi-arid areas of China.