Central Asia is a prominent area with serious water resource contradictions. Since the main rivers in this region are transboundary, the management of these rivers has a great impact on social economic development of the region and regional and social security. Research into transboundary water resource issues in this region has focused on water allocation, water prediction (including water quantity and quality), water pollution and water management. In this review, we explore this research and water resource cooperation processes between countries. Water volume is not the only water problem in Central Asia, but the management of water resources among countries is a key water problem. At present the most important question is not the establishment of the relevant management measures and plans but the establishment of the authority management organization and the implementation of agreements that have already been signed. At last a series of measures are listed for the sustainable utilization of transboundary water resources in Central Asia. In order to realize the effective management and utilization of transboundary water resources, a shared database of water resources should be established within the framework of relevant agreements of the United Nations. In order to realize the benefit maximization of water resources, a corresponding interest compensation mechanism, which will relieve water contradictions between upstream and downstream countries should be established. In addition, strengthening international or regional support in funds and technology is also necessary for the realization of regional sustainable development.