Typically, trends in long-term annual depth to groundwater and low streamflow, when analyzed across large scales, are considered separately despite the well-established concept that groundwater and surface water comprise a single resource through the lens of water availability (i.e., quantity and quality). Here, we present alternate approaches for pairing and aggregating groundwater level and streamflow data at the national scale for joint trend analysis with the goal of better understanding how these major water budget components respond simultaneously and interactively to various drivers. Results identify areas where groundwater level and low streamflow trends are responding similarly, potentially indicating well-connected surface and subsurface resources. Results also highlight regions where trends are opposing in direction or differ in significance, suggesting potential differences in resilience or vulnerability to change in the groundwater system vs. the stream network. The approach and findings developed within this study provide a basis for additional driver attribution work and for more holistic water quantity and quality management.