Water scarcity driven by population growth, lack of conventional supplies, and climate changeimpacts have resulted in increasing interest worldwide in drinking water augmentation using treatedwastewater effluents. Potable reuse can occur indirect or direct, but is also practiced in many placesas ‘de facto reuse’, where upstream wastewater discharge occurs to drinking water supplies. Withthis increasing recognition of potable reuse, there is very limited guidance and standardization forproper design and operation of potable reuse schemes that is protective of public health. This studyprovided guidance on contemporary approaches for the design, operation, and monitoring of potablereuse schemes, including source water characterization and source control approaches; linkingwater quality treatment performance goals to health risks; risk mitigation strategies including thedesign principles of multiple barriers for microbial and chemical contaminants; assessing systemreliability and fail-safe design approaches; and, finally, monitoring strategies for process performanceand compliance.