Abstract

Freshwater generated in Andean headwaters regulates ecological processes and sustains rural livelihoods, irrigated agriculture, and expanding coastal cities across western South America. Climate-driven glacier retreat, declining baseflows, land-use intensification, and institutional fragmentation increasingly disrupt this mountain coast hydrological continuum, with severe implications for biodiversity, landscape resilience, and equitable water access. Despite these interconnected pressures, few studies integrate water footprint management with human rights and Indigenous governance perspectives to assess how landscape-scale decisions shape coupled Andean–coastal socio-ecological systems. This review addresses this gap through a structured assessment of scientific literature, hydrological datasets, policy frameworks, and community case studies. Results highlight three dominant drivers of hydrological and ecological degradation: inefficient highland irrigation systems, accelerated cryosphere loss, and governance fragmentation that disconnects upstream users from coastal water security. Traditional Andean infrastructures including amunas, terracing, bofedales, and communal acequias emerge as nature-based solutions capable of enhancing infiltration, stabilizing flows, and sustaining high-altitude biodiversity. Case studies demonstrate that integrating water footprint management with indigenous ecological knowledge strengthens ecosystem services, reduces grey-water pollution reaching coastal basins, and operationalizes the human right to water. Hybrid governance models that combine remote sensing, hydrological modelling, and water footprint management indicators with community-led water management offer the greatest potential to improve landscape resilience under climate change. Embedding water footprint management into regional land- and water-use policies can protect headwater ecosystems, mitigate salinization and freshwater decline in coastal aquifers, and promote long-term hydro social sustainability across the Andes coast continuum.