The paper examines: (a) trends in climatic variations and variability with particular emphasis on rainfall (b) the characteristics of climatic events, including floods and droughts, (c) seasonal variations in river flows, (d) mean annual trends in river flows and discharges, (e) local variations of extremes of rainfall and river discharges, (f) the effects of climatic variability and climate change on ground water variations, (g) the problems of acute shortage of freshwater, and (h) the prevalence of water stress whose characteristics would be worsened with the projected impacts of climate change. The results show that: (i) there are a lot of spatial and temporal variations in the characteristics of rainfall and the hydrological systems locally and regionally, although in general, there have been downward trends in rainfall and increases in water deficits and drought events, (ii) that flood events, which also have impacted adversely in many parts of the region, have also been witnessed. The paper then produces projections for future urban and rural water supplies in Nigeria, which is an epitome of West Africa and examines the two main categories of adaptation measures needed to improve water management, namely, those involving the water supply and water demand systems in the study region. Finally, the paper discusses the need to address a number of mechanisms for implementation of the various adaptation measures including: (a) building capacity and manpower, (b) promoting education and public awareness, (c) public participation and the involvement of stakeholders, (d) the establishment of both national and regional co-operation, and (e) the need for climatic and other environmental data collection and monitoring.