Rising temperatures and changing precipitation patterns across the Hindu Kush–Himalaya (HKH) region resulting from climate change have an influence on water resource availability and food security for the downstream population. This review seeks to objectively assess the available evidence of the impacts of climate change on glacier hydrology and the wider implications upon water resources within the Indus, Ganges, and Brahmaputra basins. Glacier meltwater contribution to river flows is scale dependent and varies considerably across the east–west climatic zones of the HKH. For the Ganges and Brahmaputra this contribution is estimated to be significantly less than for the Indus to the west, with summer monsoon rains dominating flows from central and easterly areas, whereas meltwater remains a significant contributor to downstream flow of westerly basins, which receive most precipitation during winter. No corroborated trends exist in observed discharge for any basin, and such analyses are hindered by a lack of good-quality long-term data. Predicted increases in temperature will drive increased shrinkage of glaciers, leading to initial increases in meltwater produced, followed by subsequent declines with reduced glacier mass. The impacts of such changes are predicted to be minimal for the overall discharge of the Ganges and Brahmaputra, where increases in rainfall may in fact lead to increased flows but with greater variability. Within the Indus basin, reduced meltwater will have significant impacts upon available runoff; however, increased uncertainties surrounding precipitation and socioeconomic changes limit any conclusive assessment of how water availability will be affected; moreover, seasonality of runoff may be a more important factor. Scientific challenges and research recommendations are identified for the region. This review proposes the need for the scientific evidence pertaining to the region's glacier systems to be approached objectively in the future, such that a robust assessment of change can be attained.