The objective of this study was to assess and compare water access and sanitation-related behaviors with self-reported water insecurity among women. The cross-sectional study involved household observations and in-person interviews with women living in rural areas of West Cameroon (n = 134). Water insecurity was prevalent with 37% of women having affirmative responses to the statement ‘being worried about household not having enough water.’ Only 7% of the women reported having any water source (well/pump) in the household compound, and water insecurity was more common among those who did not have an ‘on premise’ water source (p = 0.038). Additionally, women walking more than 10 minutes to reach the water source were more insecure than their counterparts (p = 0.022). Amount of water stored at home was lower in water insecure households (37.07 liters) compared to secure households (58.93 liters, p = 0.042). Sanitation rate was low in the study area, with 20% of women reporting open defecation for their children. Water insecurity is associated with long distance to water source and limited water availability at the household level. Future research is needed to understand the association between water insecurity and daily water intake and related dietary behaviors.