Introduction: Often it is presumed that in high-income countries, like the United States, water insecurity is not an issue. Yet, more than 2 million individuals in the United States are affected by water insecurity. Experiencing the effects of water insecurity are informal settlements and impoverished communities termed as “colonias”, characterized by the lack of possessing basic infrastructures and services, including water systems and wastewater disposal amongst many. Purpose: To critically analyze how water insecurity manifests in the colonias and the impacts it has on the health and well-being of the community members. Methods: An extensive systematic literature review was conducted in the effort to bring a meaningful framework of existing challenges and potential resolutions and theorize water insecurity in colonias. Results: The effects of water insecurity due to water scarcity and water contamination in the colonias led to health complications, unsanitary living conditions and mental distress for residents. The causes of water insecurity in the colonias were because of political exclusion, municipal underbounding and the failure to monitor water quality. Conclusion: The dire consequences of household water insecurity to an individual, no less an entire population, are detrimental to health and well-being. Despite this acknowledgement of a critical and basic human necessity, literature reveals a robust water governance infrastructure is much needed for the people in colonias. For meaningful progress and developments to be made in addressing water insecurity for the people of colonias, this review was approached through a transdisciplinary lens - one that achieves convergence.