Drinking water can be considered an essential nutrient for dairy cattle. However, because it comes from different sources, its chemical and microbiological quality does not always reach accepted standards. Moreover, water quality is not routinely assessed on dairy farms. The microecology of drinking water sources and distribution systems is rather complex and still not fully understood. Water quality is adversely affected by the formation of biofilms in distribution systems, which form a persistent reservoir for potentially pathogenic bacteria. Saprophytic microorganisms associated with such biofilms interact with organic and inorganic matter in water, with pathogens, and even with each other. In addition, the presence of biofilms in water distribution systems makes cleaning and disinfection difficult and sometimes impossible. This article describes the complex dynamics of microorganisms in water distribution systems. Water quality is diminished primarily as a result of faecal contamination and rarely as a result of putrefaction in water distribution systems. The design of such systems (with/ without anti-backflow valves and pressure) and the materials used (polyethylene enhances biofilm; stainless steel does not) affect the quality of water they provide. The best option is an open, funnel-shaped galvanized drinking trough, possibly with a pressure system, air inlet, and anti-backflow valves. A poor microbiological quality of drinking water may adversely affect feed intake, and herd health and productivity. In turn, public health may be affected because cattle can become a reservoir of microorganisms hazardous to humans, such as some strains of E. coli, Yersinia enterocolitica, and Campylobacter jejuni. A better understanding of the biological processes in water sources and distribution systems and of the viability of microorganisms in these systems may contribute to better advice on herd health and productivity at a farm level. Certain on-farm risk factors for water quality have been identified. A practical approach will facilitate the control and management of these risks, and thereby improve herd health and productivity.