Over the past two decades, Colombia has witnessed a significant shift in the overall legal and policy domain in the water sector in order to adjust to the demands imposed by neoliberal economic reforms. Particularly in urban areas, this reform model has been deeply contested as it failed to provide low-income population with access to affordable and adequate water supply services. This paper explores how the implementation of market-driven reforms in the water supply sector has become a key factor in reproducing patterns of unequal access to water. By drawing upon case-study research conducted in Medellín, Colombia, this study investigates the causal interconnection between the commercialization and transnationalization of the city’s public multi-utility company as a strategy to be competitive in a globalized environment on the one hand, and the increasing number of households disconnected from the formal water supply networks particularly in low-income areas for non-payment of bills, on the other hand. By bringing together work on urban political ecology and neoliberalization of nature, this paper illustrates how inequalities in access to water in Medellín’s waterscape are facilitated by governance structures which are articulated to neoliberal strategies, whose social power relations are simultaneously sustained by an intertwined set of socioeconomic mechanisms, discursive practices as well as technological infrastructures.