Groundwater provides more than half of all water for drinking and irrigation worldwide. Monitoring and managing groundwater resources is essential to achieve the Sustainable Development Goals. However, groundwater resources need to be better monitored. We explored practical approaches to improve groundwater monitoring for informed decision-making, focusing on low- and middle-income country settings. Case studies from a 2023 UNC Water and Health Conference side event highlighted innovative approaches, including open-source data modeling, groundwater monitoring in humanitarian contexts, and using in situ sensors to monitor drought resilience. The case studies described field data integration, remote sensing, and technology (e.g., Modflow-USG, ModelMuse, Drought Resilience Impact Platform). Barriers to groundwater data use were identified by side event participants, including inadequate data access, insufficient collaboration and leadership, and challenges in integrating diverse data and technology. Side event recommendations included creating a central groundwater monitoring data repository, building greater hydrogeology capacity in the WaSH sector, and increasing funding for data collection and monitoring. We urge government leaders to develop regulations and build internal capacity for sustainable groundwater management. This comprehensive approach aims to address challenges and promote informed decision-making for the long-term sustainability of groundwater resources.