This research assesses climate, technological, and policy impacts on consumptive water use from electricity generation in the Southwest over a planning horizon of nearly a century. We employed an integrated modeling framework taking into account feedbacks between climate change, air temperature and humidity, and consequent power plant water requirements. These direct impacts of climate change on water consumption by 2095 differ with technology improvements, cooling systems, and policy constraints, ranging from a 3–7% increase over scenarios that do not incorporate ambient air impacts. Upon additional factors being changed that alter electricity generation, water consumption increases by up to 8% over the reference scenario by 2095. With high penetration of wet recirculating cooling, consumptive water required for low-carbon electricity generation via fossil fuels will likely exacerbate regional water pressure as droughts become more common and population increases. Adaptation strategies to lower water use include the use of advanced cooling technologies and greater dependence on solar and wind. Water consumption may be reduced by 50% in 2095 from the reference, requiring an increase in dry cooling shares to 35–40%. Alternatively, the same reduction could be achieved through photovoltaic and wind power generation constituting 60% of the grid, consistent with an increase of over 250% in technology learning rates.