During the past several years, New York City has taken a number of significant steps towards examining and protecting the quality of its drinking water supply. As the NYC supply is a surface water supply, the microorganisms Giardia lamblia and Cryptosporidium sp. are of particular interest. While there is currently no evidence of an increased illness rate nor increased waterborne risk in New York City, the city has undertaken several new programs related to monitoring the organisms and the related diseases. Programs have been developed to gather data on concentrations and potential sources of these microorganisms in the supply source waters. As well, New York City has initiated efforts to study disease incidence and potential risk factors, and to begin to examine the question of whether there is any link between drinking water consumption and waterborne disease in the City. This presentation addresses the first implemented element of the City's disease assessment efforts: active disease surveillance of giardiasis and cryptosporidiosis.