This paper explores the gender differences in water collection in Makondo Parish in Uganda as a case study. Our analysis is based on data collected from a cross-sectional survey, in-depth interviews, focus groups, and participant observation in the study area. This data confirms that children and women are most burdened by water collection. Unless it is for commercial or work-related reasons or when there is a long drought, men rarely fetch water. Our study further reveals that children and women walk distances of less than half a kilometre to more than two kilometres on rugged and hilly roads and paths, carrying water on their heads or by hand. They spend a lot of time queuing at “improved” water sources, and suffer from health complications such as prolonged fatigue, chest pain and headache as a result of carrying water. Children and women are also distressed by the dangers of verbal and physical assault and rape at both “improved” and “unimproved” water points. We contend that whereas time and distance remain important determinants of the burden of water collection, socio-cultural, environmental and health-related conditions are equally critical in understanding the troubles that children and women face while collecting water in rural developing communities.