This chapter analyzes the relevance that groundwater management acquires in drought conditions and discusses the role that it may have in the mitigation of the negative effects associated with such a phenomenon. The opportunities for groundwater exploitation constitute alternative water use, favored by the volume stored in aquifers in different regions. Drought events have increased lately, intensifying the requirement for groundwater, in particular for human consumption and agricultural use. The conjunctive use of surface water and groundwater is a technique of interest in many locations. During wet periods, the use of surface water prevails, leading to the recovery of the aquifer reserves, which are exploited more intensely during the dry periods. A groundwater reservoir appears as a strategic resource depending on its storage capacity, the availability of reserves, and its spatial distribution. Groundwater use entails a planned exploitation that takes into consideration environmental sustainability, based on the integrated management of the water resources. In order to do so, the key is a balanced use that avoids the excessive lowering of the groundwater levels (i.e., the depletion of the resource) and the deterioration of the chemical quality. An integrated management of the water resources in times of drought should be characterized by an adequate hydrogeological knowledge and their relationship with the natural ecosystems. An effective system to solve the problems resulting from droughts must implement preventive measures that would make it possible to count, well in advance, on the necessary infrastructure for groundwater supply, as well as monitoring and maintenance, which guarantee its availability if necessary.