It has become clear that estuaries with low rates of freshwater inflow are an important but overlooked sphere of estuarine science. Low-inflow estuaries (LIEs) represent a major class of estuary long downplayed because observations do not fit well in the dominant estuary paradigm, which was developed in perennially wet climates. Rather than being rare and unusual, it is now evident that LIEs are common globally and an alternate estuary paradigm within the idea of an estuary as the place where a river meets the sea. They are found mostly in areas with arid, semi-arid, or seasonally arid climates, but LIE phenomena are also found in estuaries along mountainous coasts with small watersheds and short-tailed hydrographs. Inflows can be defined as “low” relative to basin volume, tidal mixing, evaporative losses, or wave forcing at the mouth. The focus here is on common physical phenomena that emerge in low-inflow estuaries—how low river flow is expressed in estuaries. The most common is hypersalinity (and the associated potential for inverse conditions), which develops where there is a net negative water balance. However, in small microtidal estuaries, low inflow results in mouth closure even as a positive water balance may persist, accounting for extreme stratification. Attention is also given to the longitudinal density gradient and the occurrence of thermal estuaries and inverse estuaries. Finally, ocean-driven estuaries are highlighted where marine subsidies (nutrients, particulates) dominate watershed subsidies. While climate change is altering freshwater inflow to estuaries, locally driven changes are generally more important and this presents an opportunity to restore estuaries through restoring estuarine hydrology.