The important relationship between health and water necessitates consideration of water vulnerability. Water vulnerability is contingent upon biophysical and social drivers operating at multiple scales, and is difficult to assess. This paper offers a systematic review of 50 water vulnerability assessment tools. We identify and synthesise the contents of these assessment tools (710 indicators) into five dimensions and 22 sub-dimensions and consider the extent to which they reflect environmental and social aspects. The findings are discussed in light of a holistic approach to water resources management, and specifically Integrated Water Resources Management (IWRM). Significant opportunities exist to enhance the efficacy of water vulnerability assessment tools by incorporating indicators and operational measures for social considerations (e.g., adaptation, institutions, governance) that are developed outside the context of water.