Dryland wetland vegetation is, paradoxically, both highly sensitive and extremely resilient to environmental change. In the short-term, rapid responses of wetland biota and ecological processes to wetting and drying, which influence ecosystem structure and function, enable rapid reproduction which enhances long-term resilience. However, over longer periods, mechanisms such as seed dormancy and persistent seed and egg banks enable dryland wetland ecosystems to recover after major environmental perturbations such as mega-droughts or wildfire. Climate change is likely to have a significant effect on key drivers of ecological response in dryland wetlands, including hydrology and its interface with other climatic stimuli, e.g. temperature, as well as the frequency and intensity of extreme events. Like species, wetland ecosystems may respond to climate change in three main ways, namely, disappear, persist without significant adjustment, or transform. Here, we consider the conditions under which each of these responses may eventuate for dryland wetlands, by using wetland vegetation of the northern Murray-Darling Basin Australia, as a case study. We also explore what wetland transformation might entail in this region in terms of wetland ecological character and the key values this supports. Finally, we consider the implications for wetland policy and management at present and as trajectories of wetland change unfold. Dryland wetland vegetation is both highly sensitive and remarkably resilient to environmental change. In the short term, this includes rapid responses to wetting and drying. Over extended periods, these ecosystems recover impressively from major environmental disturbances such as mega-droughts or wildfire. As the effects of climate change intensify, the resilience of dryland wetlands will be challenged, leading to scenarios of persistence, transformation or disappearance. With a focus on Australia's northern Murray-Darling Basin, we explore the wetland policy and management implications.This article belongs to the collection Environmental Flows in Northern Murray-Darling Basin: what we know about the science and management after a decade of practice.