South rear-edge populations of widely distributed temperate and boreal tree species such as birches (Betula pubescens and Betula pendula) are considered particularly vulnerable to climate warming, and at the same time, they constitute genetic reservoirs of drought-adapted ecotypes. Here, we compared radial growth patterns and responses to climate, river, or reservoir flows and a drought index of rear-edge (southernmost) populations (Toledo Mountains, central-southern Spain) with populations located in northern Spain of B. pubescens and B. pendula. Then, we performed a comparative analysis across Europe of B. pendula populations. The main climatic constraint of birch growth was a high summer water deficit, although the effect of local hydrological conditions was particularly important in rear-edge populations. We found declining growth trends in rear-edge stands dating from the early 21st century, related to decreasing water availability and increasing aridity. Our results also suggested distinct growth patterns and climate-growth associations of B. pendula across Europe that show how populations further south and in warmer locations were more sensitive to drought stress. Drought-induced growth decline can be exacerbated by local human land uses, leading to reduced river inflow, thus endangering birch populations at their southern distribution limit. Protection of threatened rear-edge birch populations requires adequate management of local water resources.