Colombia is one of the largest producers of gold in Latin America and it has recently increased its production, especially in the Departments of Antioquia, Chocó, Bolívar and Córdoba, which in 2014 produced 90% of Colombia's gold. Most of this production comes from artisanal and Small-Scale Gold Mining (ASGM). Parallel with this boost in production, there is concern about the health of rivers, since many local mines discharge untreated waters and tailings directly to waterways. This situation has awakened awareness in the communities of Colombia. Water is essential to carry out daily activities and for their society and economy. This article review displays three current challenges in Colombia that have been identified with local government, universities, environmental authorities, consultants and mining industry. These challenges are: water pollution; aquifer protection; and changes in natural sedimentation in rivers. Based on previous work done in the region, this paper suggests new research directions to create opportunities for more sustainable practices. In particular, this paper identifies the opportunity to implement a series of practices to manage water and tailings at informal mining sites. The paper also highlights the importance of engaging communities, informal and formal miners, government and researchers in order to create consciousness of the importance of water in Colombia. This is an opportunity to create discussions that help miners to manage water and tailings, adapting these practices to their specific needs and through simple technologies.