Water resources in agriculture-dominated basins of the arid western United States are stressed due to long-term impacts from pumping. A review of 88 regional groundwater-flow modeling applications from seven intensively irrigated western states (Arizona, California, Colorado, Idaho, Kansas, Nebraska and Texas) was conducted to provide hydrogeologists, modelers, water managers, and decision makers insight about past modeling studies that will aid future model development. Groundwater models were classified into three types: resource evaluation models (39%), which quantify water budgets and act as preliminary models intended to be updated later, or constitute re-calibrations of older models; management/planning models (55%), used to explore and identify management plans based on the response of the groundwater system to water-development or climate scenarios, sometimes under water-use constraints; and water rights models (7%), used to make water administration decisions based on model output and to quantify water shortages incurred by water users or climate changes. Results for 27 model characteristics are summarized by state and model type, and important comparisons and contrasts are highlighted. Consideration of modeling uncertainty and the management focus toward sustainability, adaptive management and resilience are discussed, and future modeling recommendations, in light of the reviewed models and other published works, are presented.