The Hindu Kush Himalayan (HKH) region, known as the “water tower of the world,” is experiencing severe water scarcity due to declining discharge of spring water across the HKH region. This decline is driven by climate change, unsustainable human activities, and rising water demand, leading to significant impacts on rural agriculture, urban migration, and socio-economic stability. This expansive review judiciously combines both the researchers’ experiences and a traditional literature review. This review investigates the factors behind reduced spring discharge and advocates for a transdisciplinary approach to address the issue. It stresses integrating scientific knowledge with community-based interventions, recognizing that water management involves not just technical solutions but also human values, behaviors, and political considerations. The paper explores the benefits of public–private partnerships (PPPs) and participatory approaches for large-scale spring rejuvenation. By combining the strengths of both sectors and engaging local communities, sustainable spring water management can be achieved through collaborative and inclusive strategies. It also highlights the need for capacity development and knowledge transfer, including training local hydrogeologists, mapping recharge areas, and implementing sustainable land use practices. In summary, the review offers insights and recommendations for tackling declining spring discharge in the HKH region. By promoting a transdisciplinary, community-centric approach, it aims to support policymakers, researchers, and practitioners in ensuring the sustainable management of water resources and contributing to the United Nations Sustainable Development Goals (SDGs).