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The countries of Central Asia are collectively known as the five ''-stans'': Uzbekistan, Kyrgyzstan, Turkmenistan, Tajikistan and Kazakhstan. In recent times, the Central Asian region has been affected by the shrinkage of the Aral Sea, widespread desertification, soil salinization, biodiversity loss, frequent sand storms, and many other ecological disasters. This paper is a review article based upon the collection, identification and collation of previous studies of environmental changes and regional developments in Central Asia in the past 30 years. Most recent studies have reached a consensus that the temperature rise in Central Asia is occurring faster than the global average. This warming trend will not only result in a higher evaporation in the basin oases, but also to a significant retreat of glaciers in the mountainous areas. Water is the key to sustainable development in the arid and semi-arid regions in Central Asia. The uneven distribution, over consumption, and pollution of water resources in Central Asia have caused severe water supply problems, which have been affecting regional harmony and development for the past 30 years. The widespread and significant land use changes in the 1990s could be used to improve our understanding of natural variability and human interaction in the region. There has been a positive trend of trans-border cooperation among the Central Asian countries in recent years. International attention has grown and research projects have been initiated to provide water and ecosystem protection in Central Asia. However, the agreements that have been reached might not be able to deliver practical action in time to prevent severe ecological disasters. Water management should be based on hydrographic borders and ministries should be able to make timely decisions without political intervention. Fully integrated management of water resources, land use and industrial development is essential in Central Asia. The ecological crisis should provide sufficient motivation to reach a consensus on unified water management throughout the region.