The likely effects of climate change on the water resources of the eastern Mediterranean and Middle East region are investigated using a high‐resolution regional climate model (PRECIS) by comparing precipitation simulations of 2040–2069 and 2070–2099 with 1961–1990. The simulations show about a 10% decline in precipitation across the region by both the middle and the end of the century, with considerable variation between countries and international river basins. Results suggest that per capita water resources will not change particularly significantly in southeastern Europe, where they are relatively plentiful and population growth is minimal. However, in much of the Middle East, climate change coupled with population growth is likely to reduce per capita water resources considerably. This will inevitably result in major social, economic, and environmental change in the region. Countries where the required adaptation is likely to be particularly challenging include Turkey and Syria because of the large agricultural workforces, Iraq because of the magnitude of the change and its downstream location, and Jordan because of its meager per capita water resources coupled with limited options for desalination. If the internal water footprint of the region declines in line with precipitation but the total water footprint of the region increases in line with population, then by midcentury, as much as half the total water needs of the region may need to be provided through desalination and imported in the form of virtual water.