Small drinking water systems (SDWS) are widely identified as presenting particular challenges for drinking water management and governance in industrialised nations because of their small customer base, geographic isolation, and limited human and financial capacity. Consequently, an increasing number and range of scholars have examined SDWS over the last 30 years. Much of this work has been technocentric in nature, focused on SDWS technologies and operations, with limited attention to how these systems are managed, governed, and situated within broader social and political–economic contexts. This review seeks to provide a comprehensive overview of the governance dimensions of SDWS by drawing together existing literature relating to SDWS governance and exploring its key themes, research foci, and emerging directions. This overview is intended to provide guidance to scholars and practitioners interested in specific aspects of SDWS governance and a baseline against which researchers can position future work. The review identified 117 academic articles published in English-language journals between 1990 and 2016 that referred to some aspect of drinking water governance in small, rural, and Indigenous communities in industrialised nations. The articles’ content and bibliographic information were analysed to identify the locations, methods, journals, and themes included in research on SDWS governance. Further analysis of SDWS’ governance dimensions is organised around four questions identified as central to SDWS research: what governance challenges are experienced by SDWS, and what are their causes, solutions, and effects? Overall, the review revealed that the SDWS governance literature is piecemeal and fragmented, with few attempts to theorise SDWS governance or to engage in interdisciplinary, cross-jurisdictional conversations. The majority of articles examine North American SDWS, retain a technocratic orientation to drinking water governance, and are published in technical or industry journals. Such research tends to focus on the governance challenges SDWS face and proposed solutions to systems’ performance, capacity, and regulatory challenges. A small but growing number of studies examine the causal factors underpinning these governance challenges and their socio-spatially differentiated impacts on communities. Looking forward, the review argues for a more holistic, integrative approach to research on SDWS governance, building on a water governance framework.