We review over 100 years of literature on Prairie buried valleys to provide a platform for future research and policy development. Prairie buried-valley fills commonly function as aquifers that yield abundant groundwater. They have distinct geologies and a distinct stratigraphic setting, which imparts them with distinct hydrogeological properties and gives clues as to how they formed and filled. Prairie buried-valley aquifers are commonly encased in low-permeability strata: Cretaceous shale commonly underlies them, and thick (10–300 m) low-permeability Quaternary till tends to overlie them. This reduces recharge, in rare cases nearly completely, while protecting groundwater resources from contamination and drought. It also tends to lead to highly mineralized groundwater chemistries. The stratigraphic position of Prairie buried valleys also speaks to their origin: those that subtend (“hang”) from the bedrock unconformity were likely eroded by preglacial fluvial systems during late Tertiary uplift of the Rocky Mountains, whereas those that subtend from surfaces within the till package are likely glaciofluvial valleys eroded in proglacial spillway or tunnel-valley settings. Another key trait of Prairie buried valleys is that their fills tend to be heterogeneous and architecturally complex. Sand, gravel, mud, and diamicton are common; any one can dominate the fill at a given location. This heterogeneity, in conjunction with irregularity common to buried-valley bedrock floors, commonly causes aquifer compartmentalization and makes prediction of aquifer potential difficult prior to drilling. It also suggests that most Prairie buried valleys filled over time, and likely over multiple glaciations, in multiple depositional environments.