Assessment of water resources vulnerability and development of adaption measures under climate change are among the major strategic issues for sustainable development in China. This paper reviews progress in research in this field and recommends revisions in direction and emphasis. In general, research and policy-making has so far inadequately dealt with uncertainties that exist in hydrological processes. Also, there has been a tendency for research on vulnerability assessment and adaption measures to be disjointed, while evidence suggests that water shortage that threatens social and economic development is often related to poor water management. Future research in this field would benefit by: Integration of vulnerability assessment and ecological needs with appropriate adaption measures; development of theory and models of how to respond quickly to hydrological, ecological and socio-economic change; quantifying and utilizing risk and uncertainty; adopting no regrets adaptation measures; undertaking cost-benefit analysis of options with the goal of sustainable development; and greater stakeholder involvement in information provision and decision making.