Climate change in California is expected to alter future water availability, impacting water supplies needed to support future housing growth and agriculture demand. In groundwater-dependent regions like California's Central Coast, new land-use related water demand and decreasing recharge is already stressing depleted groundwater basins. We developed a spatially explicit state-and-transition simulation model that integrates climate, land-use change, water demand, and groundwater gain-loss to examine the impact of future climate and land use change on groundwater balance and water demand in five counties along the Central Coast from 2010 to 2060. The model incorporated downscaled groundwater recharge projections based on a Warm/Wet and a Hot/Dry climate future from a spatially explicit hydrological process-based model. Two urbanization projections from a parcel-based, regional urban growth model representing 1) recent historical and 2) state-mandated housing growth projections were used as alternative spatial targets for future urban growth. Agricultural projections were based on recent historical trends from remote sensing data. Annual projected changes in groundwater balance were calculated as the difference between land-use related water demand, based on historical estimates, and climate-driven recharge plus agriculture return flows. Results indicate that future changes in climate-driven groundwater recharge, coupled with cumulative increases in agricultural water demand, result in overall declines in future groundwater balance, with a Hot/Dry future resulting in cumulative groundwater decline in all but Santa Cruz County. Cumulative declines by 2060 are especially prominent in San Luis Obispo (−2.9 to −5.1 Bm³) and Monterey counties (−6.5 to −8.7 Bm³), despite limited changes in agricultural water demand over the model period. These two counties show declining groundwater reserves in a Warm/Wet future as well, while San Benito and Santa Barbara County barely reach equilibrium. These results suggest future groundwater supplies may not be able to keep pace with regional demand and declining climate-driven recharge, resulting in a potential reduction in water security in the region. However, our county-scale projections showed new housing and associated water demand does not conflict with California's groundwater sustainability goals. Rather, future climate coupled with increasing agricultural groundwater demand may reduce water security in some counties, potentially limiting available groundwater supplies for new housing.