The Northwest region of China is a major battlefield and an important ecological and environmental security barrier to China’s western development. Flourishing the Belt and Road Initiative, climate change in this region has a direct impact on water resources, ecology, and environmental security. In the context of global climate change, Northwest China has shown an obvious and rapidly developing warming-wetting trend, which has resulted in increasingly prominent environmental and public security risks that are seriously affecting the sustainable development of the regional economy and society. This poses new challenges for climate change responses, water resource management, and disaster prevention and mitigation in this region. Research on the evolution characteristics, causes, and physical mechanisms of warming-wetting as well as its future trends and possible risks were reviewed. It further summarizes the current scientific consensus and existing problems, and finally looks forward to the key directions of future scientific research. A systematic review of the trend, causes, and future projection of climate warming-wetting in Northwest China will have important scientific implications for further research on this issue.