This article describes a series of water issues and policy choices for adapting to climate-stressed river and stream systems. It addresses issues that are important both in New Mexico and internationally for which economic analysis can inform and guide ongoing policy debates. Economic analysis is needed both in New Mexico and overseas to guide plans for efficient, equitable, and sustainable water use and for reducing costs of adapting to climate-stressed river and aquifer systems. Special attention is given to three current water issues in New Mexico: climate-stress adaptation through water trading and banking, adaptation through transboundary aquifer sharing, and adaptation through headwater flow capture. All three of these measures face design and implementation challenges both in New Mexico and internationally for adapting to growing evidence of climate-stressed river systems.