Abstract: The ecological environment of inland river basins in arid regions is fragile and sensitive to climate change. In such regions, groundwater plays a crucial role in maintaining the stability of the ecosystem. However, under the combined influence of climate change and human activities, such as water diversion, irrigation, crop cultivation, and groundwater extraction, renewable and available water resources has decreased, leading to a continuous decline in groundwater levels and an increasing conflict among water uses for production, domestic needs, and ecology. To summarize recent research progress on the evolution of the groundwater cycle and its ecological effects at the basin scale in arid areas, it is urgent to conduct investigations from three key aspects: analysis, simulation, and prediction. This approach helps deepen the understanding of the driving mechanisms governing the evolution of the groundwater cycle, its role in arid region ecosystems, and the development of coupled land surface, ecohydrological, and climate models. From the perspective of the coupled river–vegetation interaction system, the impacts of human activities on groundwater hydrology and ecosystem processes were quantitatively evaluated, and the interaction mechanisms between the groundwater cycle and the ecosystem were revealed. Using a groundwater ecological function evaluation model, early warning thresholds for groundwater ecological functions were determined. Furthermore, a multiobjective management and optimization model for basin-scale water resources regulation was applied to guide groundwater resources management, and a restoration scheme for natural oases under changing environmental conditions was proposed. This study provides valuable insights into the coupling relationship between groundwater cycle evolution and ecological multiprocesses, enhances the management of groundwater resources in arid regions, and contributes to the sustainable development of fragile ecological environments.