Access to safe and clean water (Sustainable Development Goal 6 of the United Nations) is a fundamental human right and the most basic human need. However, 2.2 billion people still lacked safely managed drinking water, including 703 million without a basic water service in 2022, according to the United Nations. The current research examined the current state of water security of Burkina Faso which is one of the most vulnerable in the field of water security. The current study identifies a significant research gap in the field of sustainable water security by adopting a security-focused perspective, complementing the existing emphasis on water-related development. The present study shows that despite the numbers of water-related development projects—financed by the African Development Bank—Burkina Faso is the only country in West Africa where the proportion of the population with access to basic drinking water services has decreased (by 8%) between 2000 and 2022. Moreover, 40% of the country’s regions had fewer people with access to basic drinking water services. The research also found that Burkina Faso is the most affected by water-related conflicts in West and Central Africa where the regions of the country with the highest number of water-related conflicts are precisely those with the least access to drinking water and the least number of implemented water security projects. Thus, water security strategies must prioritize physical security, since armed conflict can easily reverse years of progress and investment.