Replacement of many old and aging bridges, culverts, and low-water crossings on rural low-volume roads is an increasing concern throughout the United States. The economic burden for many local bodies can be huge if these structures are to be replaced by a bridge or culvert. A low-water crossing (LWC) is a feasible and efficient road-stream crossing structure that can be used on these roads as an economical alternative to culverts and bridges. Three types of commonly used LWCs; unvented fords, vented fords and low-water bridges; their selection criteria, environmental considerations, design process, materials selection, signage and permitting requirements are included in this paper. Some of the issues with the existing LWCs are the safety in the crossing and effects on aquatic organism passage and surrounding environment. Through proper design, construction, and installation of proper signage, the functionality and reliability of LWCs can be improved. The study provides engineers and other practitioners in the United States and elsewhere with a proper set of information and design procedures for using LWCs.