The study described in this report, initiated by the U.S. Geological Survey in 2014, was designed to evaluate fresh groundwater resources within the Ozark Plateaus, central United States, as an area within a broader national assessment of groundwater availability. The goals of the Ozark study were to evaluate historical effects of human activities on water levels and groundwater availability, quantify groundwater resources now and under probable future pumping and climate conditions, and evaluate existing monitoring networks for their value in making better predictions of future groundwater resources. Previous studies include simulation of local-scale groundwater flow under varying temporal scales, or simulation of the regional system under steady-state conditions. While these studies are useful, particularly for the problem for which they were designed, there is a need to look at the larger regional system under transient conditions to fully evaluate the water resource over time. This study focused on multiple spatial and temporal scales to examine changes in groundwater pumping, storage, and water-level declines. The regional scale provides a broad view of the sources and demands on the system with time. The study area covers approximately 68,000 square miles in the central United States in parts of Missouri, Arkansas, Kansas, and Oklahoma and encompasses the Ozark Plateaus Physiographic Province (Ozark Plateaus), including the Salem Plateau, Springfield Plateau, and Boston Mountains. Groundwater is withdrawn from the Ozark Plateaus aquifer system (Ozark system) for public supply and for domestic, agriculture (including irrigation and aquaculture), livestock, and non-agricultural use (including industrial, thermoelectric power generation, mining, and commercial). The Ozark system provides an important drinking-water supply for people living in the Ozark Plateaus because public supply and domestic use combined constitute the largest groundwater use. Precipitation is the ultimate source of freshwater to the Ozark system; most rainfall occurs during April, May, and June, and precipitation increases generally from north to south across the study area. Groundwater use currently accounts for only 10 percent of the total water use in the areas overlying the Ozark system, but provides a critical drinking-water resource because public supply and domestic groundwater withdrawals are largely from groundwater resources. The 380 million gallons per day of groundwater withdrawn from the Ozark system in 2010 accounts for approximately 2 percent of recharge. Although groundwater use represents a small component of the hydrologic budget, because of low storage in aquifer units, cones of depression with steep water-level gradients can develop quickly around pumping centers. The amount of water entering and leaving the aquifer system from 1900 to about 1965 was relatively constant at a rate of about 13 billion gallons per day (Bgal/d). Much of this inflow of water is discharged through streams in the system to balance the hydrologic budget. Changes in storage over time (from outflows to inflows) reflect the large variability in recharge: if recharge decreases, water levels will decrease, resulting in less groundwater discharge to streams and more water released from aquifer storage. Conversely, when recharge increases, water levels increase, more groundwater discharges to streams, and aquifer storage is replenished. Although pumping generally increased from 1900 to 2016, it does not appear to correlate with the change in storage over the same time period. Regionally, simulated change in groundwater storage corresponds with changes in recharge, more so than with increases in pumping. Average recharge was 11.6 Bgal/d for the period 1900 to 2016. Recharge was generally above average from predevelopment to 1965, followed by a period of below-average recharge from 1965 to about 1980. Recharge remained consistently above average from 1980 to about 1988, after which there was a period of average or below-average recharge, reflected by a decline through the mid-2000s. The implications and potential effects of increased pumping and long-term climate change on the Ozark Plateaus hydrologic system and groundwater availability are a concern for communities and resource managers in the area. Pumping varies from year to year, but is generally expected to moderately increase with population, industrial, and agricultural needs. Most climate models predict warmer minimum and maximum air temperatures by midcentury in the Ozark Plateaus area, especially from midspring through early fall. Three scenarios were developed to simulate possible future conditions from 2016 to 2060 and assess the potential effects on the hydrologic system and availability of water resources. For each scenario, changes in water levels and hydrologic budget components were evaluated from predevelopment (1900) to present (2016) and 45 years into the future (2060). The baseline scenario represents an extension of the average (1996 to 2016) seasonal pumping and recharge values. The pumping scenario is an extension of the average (1996 to 2016) seasonal recharge values with increases in pumping following the historical trend for the period 2016-2060 of up to 120 percent of the 1996 to 2016 average seasonal pumping values. The general circulation model (GCM) scenario is an extension of the average (1996 to 2016) seasonal pumping values and variable recharge based on seasonal averages of soil water storage from a water-balance model using temperature and precipitation from multiple GCMs. The general patterns of water-level decline are similar for each scenario. The areas of water-level decline in southwest Missouri and northeast Oklahoma are only marginally different by 2060 from those of 2009. In one area south of Springfield, Mo., water-level declines are less in the baseline and GCM scenarios than in 2009. This may be the result of a transition from groundwater use to surface-water supplies for a larger percentage of the demand in the area. For all three scenarios, forecasted pumping, recharge, and aquifer properties play an important role in determining the uncertainty of water-level forecasts at 94 real-time observation wells. Simulated aquifer properties in the productive middle and lower Ozark aquifers and the St. Francois confining unit of the Ozark system contribute most to predictive uncertainty in water levels at approximately 35 percent of the real-time observation wells. Out of the 94 real-time observation wells, 82 are developed in the lower Ozark aquifer.