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Since 1971, the Centers for Disease Control and Prevention (CDC), the US Environmental Protection Agency, and the Council of State and Territorial Epidemiologists have maintained a collaborative surveillance system for collecting and periodically reporting data that relate to occurrences and causes of acute waterborne disease outbreaks. This paper is a review of data previously published by the CDC, which previously existed as yearly summaries. This paper compiles these data and looks at longer-term trends in waterborne disease. The objectives of this paper are to: examine trends in acute waterborne disease in the US, and determine if new regulations have improved the overall safety of the nation's water supplies. Results of the data are discussed.