Inland aquaculture, once a driving force behind Andhra Pradesh’s economic success, faces mounting challenges from climate change, including intensified farming practices, groundwater degradation, and salinity intrusion. Despite growing research on water quality in the Godavari Delta’s aquaculture zones, limited attention has been paid to synthesizing findings or addressing environmental and societal sustainability. This chapter provides a comprehensive literature review focusing on high-density inland aquaculture’s impact on groundwater quality and climate change. A case study on land use and groundwater dynamics in the Godavari–Krishna inter-delta is presented, employing geospatial techniques to assess climate change implications. The findings offer critical insights into the environmental consequences of intensive aquaculture and propose sustainable strategies applicable to other deltaic regions worldwide. This synthesis underscores the need for a balanced approach to harness the economic potential of aquaculture while safeguarding ecological and societal well-being.