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Extensive groundwater withdrawals in urban areas may cause water shortages, land subsidence, and water quality problems. The Quetta Valley is the largest population center in Balochistan province in western Pakistan. This area is arid and groundwater is the main water source for domestic and agricultural use. This work presents global positioning system (GPS) data and assessment of spatial and temporal variations in water levels. GPS data from two stations from mid-2006 to the beginning of 2009 show subsidence rate of 10 cmyear. Nine satellite images from 1975 to 2009 were classified and processed to quantify land cover and land use changes, which highlight an increase in agricultural areas in the central region of the Quetta Valley, as well as reduced vegetation on mountains. These data correspond to gradual temporal changes in water volumes in streams and lakes. Average temperatures have also increased and mean precipitation has decreased during this period. However, the greatest change in this area has been in population growth, which rose from 260,000 in 1975 to 1.2 million in 2010, mainly due to migration of refugees from war-torn neighboring Afghanistan. The Quetta Valley provides a good example for studying the impact of urbanization on water resources.