Through the provision of drinking and agricultural irrigation water, groundwater resources fundamentally underpin the existence of modern human society across large regions of the world. Despite this, decades of unsustainable exploitation have led to acute degradation of groundwater quantity and quality, creating pressing challenges that society must address if we are to maintain viable access to this crucial resource for future generations. Taking stock of the current situation, in this contribution we begin by reviewing some of the major global groundwater resource pressures, before exploring a range of technological, engineering, societal and nature-based solutions to address these challenges. We look at examples of emerging groundwater resource threats and potential innovative solutions to tackle them, before concluding with a forward look at future research opportunities that can ultimately enhance our management of this vital resource.