This study applied the Water Poverty Index (WPI) in border colonias of west Texas. The colonias are mostly unincorporated communities located primarily in New Mexico and Texas along the border with Mexico and are characterized by high poverty rates and sub-standard living conditions. In Texas, access to drinking water and sanitation services has been identified as one of the most significant determinants of health in over 350 colonias with about 50,000 residents. The WPI is a multidimensional measure that links household welfare with water availability which has been applied primarily in water poor countries. WPI components were identified and prioritized by a wide range of state stakeholders. This study demonstrated that the WPI can be an effective tool in integrating physical, social, economic and environmental information and in determining priorities associated with the water situation in wealthy countries with water poor communities such as colonias. These results highlight the need to classify the water necessities of colonias using a comprehensive but simple assessment tool that integrates several factors and is not based solely on infrastructure. They provide information that can be used by policy makers to provide assistance to Texas border communities with the greatest need.