The practice of potable water reuse has evolved in important ways in the United States over the past 50 years, especially during the last 25 years. Prior to the 1990s, many cities and public health regulators recognized that municipal wastewater effluent accounted for a significant fraction of the surface water entering their drinking water treatment plants. Wastewater utilities generally addressed this situation by treating and disinfecting effluent consistent with Clean Water Act permitting requirements and, where feasible, minimizing the fraction of wastewater in drinking water intakes. Because of concerns associated with the presence of wastewater and contaminants from other sources (e.g., industrial pollution, agricultural runoff), some cities began to upgrade drinking water treatment plants by installing advanced treatment technologies to provide enhanced safeguards for public health protection. As water availability and water quality issues became more prevalent in rapidly growing areas, water managers soon began to explicitly consider the use of wastewater effluent to augment water supplies.