The purpose of this retrospective is to inform the water and sanitation industry and the general public about technologies deployed in rural Alaskan villages between ~1970 and 2005. We indicate, per interviewee input, why the majority failed on a technical level or failed to provide adequate water on an as-used basis to improve health outcomes. This retrospective will supplement prior, and often meager, documentation of unsuccessful approaches to water and sanitation in Alaska, as both a cautionary tale and as a benchmark against which progress can be made.