This study presents an analysis of up to 30 years of hydrological variables and selected water quality parameters (pH, SO4, Fe, Cu, and As) in the upper area of the Elqui River basin in North‐Central Chile. A correlation analysis determined statistically significant positive relationship for SO4‐Cu, Fe‐As, and Fe‐Cu. In terms of historical behaviour, no statistically significant trends were detected for precipitation or temperature. In contrast, for flow, there is an overall decreasing pattern for the entire area of study, although only in one case this trend was statistically significant. Along with the aforementioned analysis, a characterization of the flow‐water quality relationships is considered for the time period analyzed. Although erratic behaviours were confirmed, a negative (i.e., inverse) flow‐concentration relationship was identified for SO4, a positive (i.e., direct) relationship for Fe, and undefined relationships for As and Cu were obtained. From these analyses and based on previous studies on projections regarding climate change for the Andean region, and in particular for the upper Elqui zone, an estimation of the possible effects of the change in water regimes on water quality in the area of study is developed. It is likely that a decrease in surface flow, as a consequence of climate change could translate into improvements in water quality in terms of Fe and eventually As and Cu, but into an impairment in the case of SO4. In any case, this is a complex situation that demands special attention in the face of industrial activities that could be developed in tributaries like the Claro River, which currently play an important role in depurating or diluting contaminants in the waters of the Elqui River. Finally, it should be noted that this study addresses an issue that goes beyond the local interest and could be used as a reference to compare other transitional environments containing sulphide ores or areas of hydrothermal alterations, which are considered to be highly vulnerable to climate change and variability.