The private sector continues to play an important role in filling local drinking water supply gaps across the Global South. In West Africa, a perfect storm of rapid population growth, infrastructure mismanagement, and globalization of consumer markets has resulted in the advent of an entire new industry around packaged water, primarily ‘sachet water’ sold in mechanically sealed plastic sleeves. Most local governments and international development agencies have historically perceived sachet water as a passing trend, but it has quickly become a primary drinking water source for the majority of households in many urban areas and continues to spread throughout the region and world. Sachet water is now an important component of regional water security, although with attendant issues related to governance, quality control, environmental pollution, and social justice. This paper reviews the seminal literature on sachet water in West Africa, with particular emphasis on Ghana and Nigeria, where most studies have focused. This review synthesizes governance issues, consumer and industry trends, and the latest on product quality in the literature from 2011 to 2016, with 2010 approximating an inflection point for the modernization of the industry. The ability of many West African nations to achieve universal access to safe drinking water may depend on their willingness to understand and incorporate the sachet water industry into an integrated drinking water platform.