A synthesis of groundwater ages, recharge rates and information on processes affecting groundwater quality in northern China highlights the major challenges faced for sustainable management of the region s groundwater. Direct recharge rates range from hundreds of millimetres per year in the North China Plain, to tens of millimetres per year in the Loess Plateau to less than 4mm/year in the arid northwest. Recharge rates and mechanisms to deep semiconfined and confined aquifers are poorly constrained; however, on the basis of available data, these are likely to be mostly negligible. Severe groundwater level declines (0.5-3m/year) have occurred throughout northern China in the last three to four decades, particularly in deep aquifers. Radiocarbon dating, stable isotope and noble gas data show that the most intensively extracted deep groundwater is palaeowater, recharged under different climate and land cover conditions to the present. Reservoir construction has reduced surface runoff in mountain-front areas that would naturally recharge regional Quaternary aquifers in many basins.