<p>Urban water utilities (UWU) face escalating challenges from rapid urbanization, climate change, aging infrastructure, and institutional fragmentation. This review synthesizes evidence from 62 peer-reviewed studies to critically examine how risk analysis and management are conceptualized and applied in UWU across diverse geographies and economic settings. Through thematic dimensions on geospatial factors, including climate, terrain, population density, Gross Domestic Product (GDP), and water governance structures, along with institutional data, the study employs descriptive patterns, statistical analysis, and cross-regional comparison to explore the distribution and drivers of water risks in UWU. Email correspondence with corresponding authors was conducted to evaluate the implementation status of proposed recommendations and the translation of research findings into practice. The risks are categorized into two types: natural and anthropogenic. The latter includes operational, health and safety, financial, and socio-political risks. The paper evaluates six major risk analysis methodological categories, which vary in terms of data requirements and suitability for different types of risk. These approaches provide valuable interpretations, but many applications represent one issue, often neglecting cascading effects and dynamic interdependencies between risk domains. The review identifies critical research and practice gaps and emphasizes the need for integrated and adaptive risk governance that bridges academic knowledge and utility practice to enhance the resilience of UWU.</p>