This article aims to evaluate the current state of groundwater management in the state of Piauí, considering the scenario of climate change and its adverse effects on aquifers. The analysis is based on the socioeconomic reality of the state, the availability and demand of groundwater resources, and the level of management and the possible impacts of climate change on the state. What is noticeable is that for the projected scenarios of climate change in the state, groundwater becomes a strategic source in mitigating the effects of climate change; however, the diagnosis produced shows that the state has already been using this resource too much, but without an efficient control of the public power. This combination tends toward a pessimistic view of both the state and groundwater in relation to climate change.