Blueways can help improve health and quality-of-life by providing places for exercise, recreation, and community gatherings. The Rouge River Watershed is an industrialized region in Southeast Michigan with high rates of chronic disease and historic disinvestment in social and environmental conditions. The purpose of this article is to describe the process taken to develop an equitable, community-driven vision and approach for developing a water trail along the Lower Rouge River and to identify the key elements that emerged. Project leaders incorporated community-driven planning, community outreach, and community ownership strategies. The Rouge River Water Trail Leadership Committee engages the public, those affected by decisions, with a transparent, fact-based process. The public is given equal status and shares decision-making authority. This approach led to the development of a Water Trail Strategic Plan, community-informed recommendations for capital improvements, development of key relationships, and coalitions that provide a vehicle for ongoing community engagement and ownership. Five main elements, considered through an equity lens, go into building a water trail: (1) creating access points, (2) water quality monitoring, (3) woody debris management, (4) signage, and (5) developing a safety plan. Water trail development should consist of (1) environmental change through the creation of access points and safe, navigable waterways and (2) opportunities to utilize the infrastructure through programming and initiatives to make the trail accessible to all communities.