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Urban areas such as megacities (those with populations greater than 10 million) are hotspots of global water use and thus face intense water management challenges. Urban areas are influenced by local interactions between human and natural systems and interact with distant systems through flows of water, food, energy, people, information, and capital. However, analyses of water sustainability and the management of water flows in urban areas are often fragmented. There is a strong need to apply integrated frameworks to systematically analyze urban water dynamics and factors that influence these dynamics. We apply the framework of telecoupling (socioeconomic and environmental interactions over distances) to analyze urban water issues, using Beijing as a demonstration megacity. Beijing exemplifies the global water sustainability challenge for urban settings. Like many other cities, Beijing has experienced drastic reductions in quantity and quality of both surface water and groundwater over the past several decades; it relies on the import of real and virtual water from sending systems to meet its demand for clean water, and releases polluted water to other systems (spillover systems). The integrative framework we present demonstrates the importance of considering socioeconomic and environmental interactions across telecoupled human and natural systems, which include not only Beijing (the water-receiving system) but also water-sending systems and spillover systems. This framework helps integrate important components of local and distant human–nature interactions and incorporates a wide range of local couplings and telecouplings that affect water dynamics, which in turn generate significant socioeconomic and environmental consequences, including feedback effects. The application of the framework to Beijing reveals many research gaps and management needs. We also provide a foundation to apply the telecoupling framework to better understand and manage water sustainability in other cities around the world.