Implementing the newly recognized human right to water (HRtW) poses a variety of challenges for states and raises questions for researchers about how to evaluate the fulfillment of the right. This article sheds light on these questions by exploring the HRtW in Bolivia, a global symbol for HRtW campaigns. The article explores the Bolivian government's approach to implementing the HRtW and evaluates the fulfillment of the right based on access and investment levels, changes to institutions, and analysis of the sociopolitical context in which these changes take place. While the Bolivian state is progressively realizing the HRtW by global standards of access and investment levels, the broader criteria for the HRtW, including citizen participation and democratic decision making, remain largely unfulfilled. This case suggests that, while building state capacity to fulfill socioeconomic rights is key to rights fulfillment, pathways of horizontal and vertical accountability must also be built and strengthened.