Drinking water projects in rural Alaskan communities face a myriad of issues, often due to environmental challenges and financial constraints. These issues threaten community members’ access to clean drinking water. Here, we report the built, natural, and social system factors that contribute to the failures and successes of water projects based on 20 semistructured interviews with engineers, program managers, service providers, and researchers whose work involves some element of water infrastructure in rural Alaska. Using a hybrid deductive and inductive approach to qualitative coding analysis, we aimed to uncover common themes in the perspectives of the individuals who maintain and operate drinking water projects to advance understanding of rural water access. Interviewee responses indicate the importance of the interactions between built system factors (e.g., operations and maintenance), social factors (e.g., community engagement), and natural system factors (e.g., water quality) in determining the success of drinking water projects. Generally, the respondents agreed that design efforts that are rooted in the built and social systems (e.g., sociomaterial approaches) and that consider rural Alaskan communities’ climate, geography, and cultures allow for the effective implementation of sustainable drinking water projects.