Cryptosporidium parvum infection occurs worldwide in urban and rural populations, and waterborne outbreaks have been associated with consumption of contaminated drinking water and water during recreational activities. This article reviews the epidemiology and causes of waterborne outbreaks that have been reported in North America and the United Kingdom. The authors obtained information about the epidemiology, water system deficiencies, and water quality from 35 waterborne outbreaks. Includes 86 references, tables.