Canada is fortunate to have an abundance of freshwater, and almost 20% of this is found in the Northwest Territories (NWT). Particular concern for the implications of climate change on the Mackenzie Delta, and the influence of land claims on water governance, make the Inuvialuit Settlement Region (ISR) in the NWT an important case study. Using a systematic literature review, thematic content analysis of 116 documents was conducted to understand how water is used and managed across scales in the ISR. A number of unique challenges emerged for the ISR in comparison to the Canadian water security context. Thus, a more tailored vision of water security needs to account for: cultural practices and well-being tied to uses of water/snow/ice, financial and capacity challenges related to remote locations, Indigenous land claims and governance complexities, ice as infrastructure, and high latitude sensitivities to climate change and contamination.