Coastal groundwater (CGW) is a critical water resource for many communities and can be a key part of coastal ecosystems. Owing to its location, CGW faces both terrestrial and marine effects of climate change while simultaneously being impacted by anthropogenic activities. In this Review, we discuss the expected impacts of climate change on CGW and CGW-dependent ecosystems. Sea-level rise, coastal flooding increases and precipitation and aridity changes will drive alterations in the amount, chemistry and fluxes of CGW. Impacts could also arise from changes in storm and cyclone activity, land and ocean temperature rises, cryosphere melt, ocean chemistry and coastal erosion, but the overall effect is understudied. Human-induced stressors, such as groundwater extraction, will interact with climate change impacts to alter CGW at different temporal and spatial scales. CGW-associated ecosystems are expected to respond to changes in an ecosystem and site-specific manner — for example, some coastal temperate and tropical ecosystems might be more impacted by seawater intrusion owing to sea-level rise and coastal flooding, whereas others, such as coastal polar ecosystems, could be more affected by increases in cryosphere melt. A comprehensive and global CGW observatory programme is needed to better understand baseline CGW conditions, track change and support resource management.