The article provides an overview of regional studies addressing the hygienic safety of recreational and drinking water use of the population of the Upper Don basin, conducted on the territory of the Voronezh region. The results of dissertation research for 1997–2019 and materials of modern scientific publications on the studied problem for 2015–2019, showing priority regional problems of water use of the population of the Upper Don Basin are considered. The data of scientific and practical work and state monitoring on the inconsistency of water quality with current standards in places of recreation at water bodies and drinking water of centralized water supply systems for sanitary and chemical indicators and microbiological safety indicators are presented. A description of the current system for monitoring the state of water resources is presented and attention is drawn to the need for its improvement.