Climate change is projected to have a strongly negative effect on water supplies in the arid mountains of South America, significantly impacting millions of people. As one of the poorest countries in the region, Bolivia is particularly vulnerable to such changes due to its limited capacity to adapt. Water security is threatened further by glacial recession with Bolivian glaciers losing nearly half their ice mass over the past 50 years raising serious water management concerns. This review examines current trends in water availability and glacier melt in the Bolivian Andes, assesses the driving factors of reduced water availability and identifies key gaps in our knowledge of the Andean cryosphere. The lack of research regarding permafrost water sources in the Bolivian Andes is addressed, with focus on the potential contribution to mountain water supplies provided by rock glaciers.