The Arizona 20" gauge lines, in my book, account for the narrowest narrow gauge in the U.S. These were not built out of romance or for tourism goals. Pure functionality, and from what I gather, they even carried passengers. I wonder what their coaches looked like! I figure an 18 or 20" gauge coach could be configured to have a seat on each side and an aisle down the middle, but there is little proof (that I know of) with this being done. Much of the Coronado railroad was broadened (to 30"!) but they kept a bit of 20" to the mines. See the link below for pictures and info.
Other 20" in the news includes this neat little steamer from a sugar mill now in tourist service near Lima, Peru. Visit Rob Dickenson's International Steam page for more gems of info like this!
Some 15" gauge railroads elswhere do operate, and serve real transportation functions. Yet I don't consider them the narrowest railroads - without being able to stand in a car, the trains lean to the miniature side.