Water insecurity poses a complex challenge for the western United States. Large populations are exposed and susceptible to physical and social factors that can leave them with precarious access to sufficient water supplies. Consideration of social issues by water managers can help ensure equitable supply. However, how social factors affect water insecurity conditions remains unclear. This paper reviews literature on how social vulnerability influences water insecurity in the western United States. Through a meta-analysis, indicators measuring how dimensions of social vulnerability influence water insecurity were classified and hierarchical clustering was used to characterize the relationships among these vulnerability dimensions for the largest water-users—the agricultural and municipal sectors. The study then assessed uncertainty associated with social vulnerability dimensions and their indicators. There is greatest evidence for the influence of demographic characteristics, socioeconomic status, and exposure. Indicators of these determinants were mainly significant and exacerbated conditions of water insecurity. Evidence for indicators of social dependence and special needs populations was limited, although studies assessing these factors showed significant agreement on their influence on water insecurity. Conceptual framings of social vulnerability and water security determined which indicators were measured, whereas studies of the water-use sectors focused on differing associations of social vulnerability. These findings indicate the importance of recognizing the different contexts posed by water-use sectors and diverse conceptual framings. Further, some determinants such as living conditions remain important but underexplored drivers of a community's experience of water insecurity. Understanding the uncertainty associated with these measures has implications to equitable decision making.