Motivated by the limited attention given to water management in industrial symbiosis research, this study presents the first global review of water innovation practices in the implemented industrial symbiosis cases reported in literature. We analyze the prevalence of global water innovation practices extending beyond the commonly used broad practices of water treatment and reuse to propose six categories, including utility sharing for alternative water supply, utility sharing for wastewater treatment, water recovery, energy recovery from water, material recovery from water, and material exchange to enhance water/wastewater treatment. Our findings highlight regional variations in adoption, with Asian and Europe showcasing diverse practices. Additionally, they indicate that most symbiosis cases center on the extensive role of public utilities and shared water facilities in pursuing water innovation, while ‘pure’ interfirm water-related symbiosis is limited. Finally, this review highlights extensive knowledge gaps and research needs in advancing sustainable water management and innovation in industrial symbiosis. Overall, our study contributes to the development of a comprehensive framework for water innovation practices in industrial symbiosis and emphasizes the need for future research in this area.