Adequate water governance is necessary for the world’s sustainability. Because of its importance, a growing literature has studied ways to improve water governance, beginning in the early 2000s. Institutions, which refer to the set of shared rules, codes, and prescriptions that regulate human actions, are a particularly important element of sustainable water governance. Evidence shows that to design institutions that will generate sustainable economic, ecological, and cultural development, it is necessary to consider ecosystems and socioeconomic-cultural systems as social-ecological systems (SESs). In the past, practitioners and international agencies tried to find the government-led panaceas, but this search has been largely unsuccessful. Current views support efforts to move towards addressing complexity (e.g., Integrated Water Resources Management), and search for the fit between the institutional arrangements and SESs’ attributes. The literature on institutional fit in SESs encourages planners to design institutions by carefully considering the defining features of the problems they are meant to address and the SES context in which they are found. This literature has been developing since the 1990s and has identified different types of misfits. A comprehensive fitness typology that includes all the different types of fitness (ecological, social, SES, and intra-institutional fit) helps organize existing and future work on institutional fit and provides a checklist for governments to be used in the problem-solving process for increasing fitness. The water governance and institutional fitness literature provide examples of management practices and mechanisms for increasing institutional fit for each fitness type. Future research should focus on improving the methodologies to measure different types of fit and testing the effect of introducing fit on SES outcomes.