High Mountain Asia contains the largest volume of glacier ice outside the polar regions, and contain the headwaters of some of the largest rivers in central Asia. These glaciers are losing mass at a mean rate of between -0.18 and -0.5 m water equivalent per year. While glaciers in the Himalaya are generally shrinking, those in the Karakoram have experienced a slight mass gain. Both changes have occurred in response to rising air temperatures due to Northern Hemisphere climate change. In the westerly influenced Indus catchment, glacier meltwater makes up a large proportion of the hydrological budget, and loss of glacier mass will ultimately lead to a decrease in water supplies. In the monsoon-influenced Ganges and Brahmaputra catchments, the contribution of glacial meltwater is relatively small compared to the Indus, and the decrease in annual water supplies will be less dramatic. Therefore, enhanced glacier melt will increase river flows until the middle of the twenty-first century, but in the longer term, into the latter part of this century, river flows will decline as glaciers shrink. Declining meltwater supplies may be compensated by increases in precipitation, but this could exacerbate the risk of flooding.