Addressing global challenges of inequitable and unsustainable natural resource management is imperative. South African water management serves as a critical case study allowing for the deep exploration of the intricate complexities surrounding these issues. South Africa's apartheid era witnessed inequitable water distribution and, despite the efforts made through the post-apartheid National Water Act of 1998 to prioritise equity and sustainability, challenges still persist in its implementation. This review aims to bridge knowledge gaps in sustainable water management in South Africa, focusing on environmental justice and sustainable development within the framework of the three pillars of sustainability. Through a systematic literature review of 57 scientific papers published in the Web of Science database between 1995 and 2021 this study aims to provide a comprehensive examination of the complex dynamics shaping water management in South Africa. Major themes, challenges, and solutions in sustainable water management are identified, emphasising the importance of stakeholder interactions, insufficient collaboration, and a lack of capacity building. The study also explores water policy implementation, environmental impacts of business, particularly in agriculture and mining, and the management of freshwater sources and their overexploitation. Economically, the mining industry's role and associated challenges such as acid mine drainage and water use competition are assessed. The Water-Energy-Food Nexus's influence on water management, water pricing efficiency, user willingness to pay, and the potential of decentralised systems and corporate social responsibility are also explored. With South Africa facing urgent challenges of water scarcity and resource management, integrated approaches that consider environmental, social, and economic dimensions, alongside robust multi-stakeholder collaboration, are essential. This review offers valuable insights for policymakers, water managers, and researchers working toward a sustainable water future in South Africa.