Globally, water resources for cities are under increasing stress. Two main stressors are climate change and population growth, but evaluating their relative impact is difficult, especially because of the complex topology of water supply. This is especially true in the tropical Andes, which is a region with strong climatic gradients and topographical limits to water resources. This paper presents an evaluation of both stressors on water resources in a geospatial framework to identify gradients in water availability that may lead to conflicts over water use. We focus on four major cities in, or receiving water from, the tropical Andes. A multimodel data set of 19 climate models is used as input for a regional water balance model. Per capita water availability is evaluated along topographic gradients for the present and for future scenarios of population growth and climate change. In all cases, the median projection of climate change suggests a relatively limited impact on water availability, but uncertainties are large. Despite these uncertainties, we find that the expected demographic changes are very likely to outpace the impact of climate change on water availability and should therefore be the priority for local policy making. However, distinctive geospatial patterns characterize the supply systems of the studied cities, highlighting the need to analyze the topology of water supply within an ecosystem services context. Our approach is flexible enough to be extended to other regions, stressors and water resources topologies.