While mountain water faces threats posed by climate change, particularly in snow-dominated and glacierized systems, the role of groundwater in sustaining streamflow in these systems remains elusive. Changing mountain headwaters, marked by reduced snowpacks, retreating glaciers, shifting precipitation patterns, and rising temperatures, pose a crucial question: what is the resilience of streamflow in these mountains, and what role does groundwater play in this resilience? This is particularly uncertain in tropical high mountains where the seasonality of precipitation and glacier melt govern streamflow generation. A glacio-hydrological model was created using the Cold Regions Hydrological Modelling platform to investigate cryosphere-surface water-groundwater interactions in the Quilcayhuanca Basin, in Peru’s Cordillera Blanca. The model was forced by in-situ meteorological observations and parameterized using numerous data sources and process-based studies in the basin. Model results show that during the dry season, 37% of streamflow is generated from groundwater discharge, increasing to 56% during the lowest flows. Evapotranspiration is the largest mass flux from the basin at the peak of the dry season. Precipitation, temperature, and glacier change scenarios were used to assess the sensitivity of basin hydrology to climate change and glacier retreat. In a warmer, wetter, and nearly deglaciated future, Quilcayhuanca basin streamflow is expected to decrease by 4-19% annually, with a larger volumetric change in overland and vadose zone flow than in groundwater flow. The range in values is more closely linked to uncertainty in precipitation change than temperature change. Despite a strong reduction in snow and ice contribution to streamflow with warming and deglaciation, the concomitant increase in precipitation can limit the changes in streamflow and groundwater flow, showcasing the resilience of the system to shifts in climate and glacier cover.