The objectives of the study are to understand the variability and changes in hydroclimatic variables in space and time dimensions, and to evaluate the performance of managed aquifer recharge (MAR) for sustainable water resources management in northwest Bangladesh. The study reveals that groundwater resource in the northwest Bangladesh is under stress. The stress has developed and it increases over the years, as a result, shallow groundwater resource has already become scarce. The people of the area are not getting even drinking water using their hand tube wells (HTWs) during the dry season and facing trouble with irrigation water. These problems are becoming acute as a result of uncontrolled and unplanned groundwater abstraction for irrigation. Moreover, rainfall in the study area decreases and dryness increases. Higher values of the seasonality index (¯ SI = 0.87) and precipitation concentration index (PCI = 19.8) are indicators of frequent dry spells. The area suffered from 12 moderate-extreme droughts during 1971-2011, and moderate to high drought risk (B) prevails in the area. The frequent drought, decreasing trend in rainfall, transboundary river flow, and thick clay surface lithology along with the uncontrolled irrigation are also responsible for rapid depletion of groundwater. As the annual surplus of water (average = 594 mm) is higher than groundwater recharge (330 mm), an experimental study on managed aquifer recharge (MAR) has been conducted to enhance the groundwater recharge. It shows good performance for restoring the groundwater without creating any sorts of hazards. Moreover, almost 5% of irrigated land can be irrigated from surface water sources by re-excavating the rivers, Kharis (small channels). It is necessary to prepare an integrated water resource management plan (IWRMP) considering the impacts of climate change, drought risk, driving factors of the groundwater resource depletion, and rainwater as a resource for achieving the sustainability.