Mountains, provide crucial water resources for the development of human society, are the water towers of the world. However, mountain water resources have undergone marked changes in recent decades, posing a threat to sustainable human development. Based on long-term hydrological, meteorological, and related environmental data, this study analyzes the evolving patterns of water resources in China's mountains over the past 50 years using trend analysis methods. The results indicate that surface water resources in China's major mountains have undergone noticeable changes over the past 50 years, with varying trends among different mountains. The Qinghai-Tibet Plateau and Tianshan regions show an overall increasing trend in surface water resources, while the Hengduan Mountains, Taihang Mountains, Qinling Mountains, Changbai Mountains, and Yunnan-Guizhou Plateau have witnessed decreasing trends to varying degrees. Furthermore, there are differences in the primary processes influencing surface water resource changes across various mountains. For example, climate change plays a predominant role in driving surface water resource changes in the high-altitude Qinghai-Tibet Plateau and Tianshan region, while human-related activities exert a stronger impact on surface water resource changes in other mountains. To address the challenges brought about by changes in China's mountain surface water resources, it is crucial to take into full consideration the unique natural environments and social systems of each mountain.