Over the past three decades, much progress has been made in providing water and sewer service to many colonias in the U.S./Mexico border region. However, 134,419 people living in 604 colonias in the border region do not have access to public water systems and/or sewer services. Most of the remaining communities who lack water and sanitation service are relatively small, remote, and isolated, which makes providing services very expensive or perhaps even impossible. We present here two case studies that are representative of these smaller communities, still lacking in water and/or sewer services and are challenged to realize the 2030 Agenda goal of “availability and sustainable management of water and sanitation for all.” The two case studies are water insecure communities that are predominantly Hispanic and impoverished, one that is reliant on hauled water for household use (Las Pampas), and the other that is reliant on old, failing septic tanks for sanitation (Bejar Estates). Our objective in the case studies was to assess the public health and quality-of-life impacts of water insecurity as indicators of environmental injustice. We argue that though water and sanitation infrastructure is a significant contributor to addressing inequities in the border region, much remains to be done to achieve water justice in this challenging region. The “soft path to water” might be the water policy that can address the water injustice remaining in the U.S./Mexico border region.