Taiwan faces significant water resource challenges driven by pronounced seasonal variability, regional hydrological contrasts, and growing anthropogenic pressures. To mitigate shortages and uneven distribution, this article emphasizes the urgent need for integrated water resource management that jointly considers surface water and groundwater. Building on principles of sustainability and resilience, we synthesize recent advances in hydrological modeling, sediment transport analysis, and infrastructure optimization—including reservoir desiltation, seawater desalination, rainwater harvesting, and assessments of land subsidence from groundwater extraction. Particular attention is given to spatial sediment dynamics across river reaches and their implications for enhancing storage capacity. We further evaluate the feasibility of single-unit seawater desalination facilities in Taiwan’s coastal zones, analyzing energy demand and unit water costs under varying scenarios. Design guidelines for rainwater harvesting systems are proposed to reflect the distinct hydrological characteristics of northern and southern Taiwan, while integrating ecological resilience and cultural narratives. By bridging technical rigor with socio-cultural perspectives, this article offers a holistic framework for sustainable water resource planning in Taiwan and comparable island contexts. Finally, we outline preliminary guidelines for incorporating artificial intelligence into future management strategies. This research proposes reasonable cost reflection, differentiated water pricing, recycling goals, and a social equity perspective. These measures all have positive indicator benefits for the implementation of carbon budget management, global energy conservation, carbon reduction, and zero-carbon emission goals, and the achievement of carbon reduction targets of 40% reduction by 2030 and 50% reduction by 2050 for Taiwan.