Climate change and water resource issues are global problems of common concern to the international community, and they are major bottlenecks affecting the eco-environment and sustainable socio-economic development in the arid region of Northwest China. On the basis of results from previous studies, this paper points out that the unique landscape of Northwest China increases the complexity and uncertainty of the climate system. This paper analyzes the key constraints on socio-economic development and ecological security in the region, discusses the impact of climate change on water resources in Northwest China, identifies common themes and the main problems present in research on climate change and water resources in the arid northwest region, and finally, based on the importance and urgency of conducting research on the region’s water resources, proposes scientific problems that need to be addressed: first, the impact of climate change on the formation, conversion and future trends of water resources in the region; second, bidirectional coupling of high-resolution regional climate models and water cycle models of arid region land surface patterns; third, the impact of climate change and human activities on water resources of the arid northwest region. Through consideration and discussion of the above, this paper seeks to further clarify specific areas of research on pressing issues related to climate change and water resources in Northwest China, so as to establish a solid scientific basis for significantly enhancing our ability to respond to climate change and water shortages.