The páramos, a neotropical alpine grassland-peatland dominated biome of the northern Andes and Central America, play an essential role in regional and global cycles of water, carbon, and nutrients. They act as water towers, delivering water and ecosystem services mainly from the continental water divide at the Andean highland down to the Pacific and Amazon regions. The anthropogenic influence in form of the climate crisis exerts enormous pressures on these identified “hotspot” ecosystems and increases the vulnerability of nearby populations undermining the socio-economic and human development. Further, increasing pressures reduce the resilience to face climate shocks, and dramatically alters the hydro-climatic regime and shifts the páramos from long-term carbon sinks towards carbon sources. Despite their importance and vulnerability, only three decades ago, páramos, were globally among the least studied ecosystems. However, researchers have since identified them as ideal targets for solving water scarcity issues and to offset carbon emissions. Increasing awareness of the need for hydrological evidence to guide sustainable management of the páramos prompted action for generating data and to fill long-standing knowledge gaps. This has led to a remarkably successful community-research-policy effort to generate this knowledge. The combination of well-established and innovative approaches was used to data collection, processing and knowledge extraction. In this review, we provide a short overview of the state of knowledge of the hydrometeorology, flux dynamics, anthropogenic and the influence of extreme events in the regional páramos. Then, we present emerging technologies for hydrology and water resources research and management applied to páramos. Lastly, we discuss how converging science and policy efforts have leveraged traditional and new observational techniques to generate an evidence base that can support the sustainable management of the páramos. We conclude that this co-evolution of science policy was able to cover different spatial and temporal scales. Finally, we outline future research directions to showcase how sustainable long-term data collection can be sustained for the responsible development of páramo water towers.