Groundwater resources at all times have provided and continue to provide a significant impact on the economic, social, and often political activities of any state, especially if the reserves of this strategic resource are limited. Coordinated groundwater resources management is one of the main conditions for the sustainable development of countries’ transboundary basins, affecting all aspects of human activity, including water supply, agriculture, industry, hydropower, water transport, environment, and the very quality of human life. Modern international trends in the field of transboundary groundwater resources management is undergoing significant changes. This article dwells upon the features of groundwater as a mineral, the structure of state groundwater management in the Russian Federation, the regulation of transboundary groundwater use, and protection at the international and domestic levels are analyzed. The system of management of the transboundary aquifers of Kazakhstan and Belarus is considered in more detail. The unitization approach used for coordinated development of oil and gas fields can, to some extent, serve as a model for managing common groundwater aquifers located on the border of neighboring states. Dogmatic and comparative legal methods consisting of analyzing the applicable legal regulations on the use and protection of groundwater were used. Several recommendations for improving the system of state sustainable management of groundwater resources at the global level are proposed.