Numerous studies point to the growing need in the United States to invest billions of dollars over the next 20 years to improve drinking water and wastewater infrastructure. How will such a massive investment be felt at the household level. That question and the need for decision makers at all levels to know the answer provided the impetus for The Cost of Clean and Safe Water, a joint project of the New England Interstate Water Pollution Control Commission, EPA New England, the New England states, and New York State. Represented in this report are the results of a year-long effort to collect and analyze cost data from drinking water and wastewater systems serving communities throughout our region. More than 200 systems provided budget data for on-going capital improvement projects, facility upgrades, and the cost of daily operations and maintenance. Using these data, NEIWPCC projected the maximum annual household cost for each community over the next 20 years. Data are presented as household costs for two reasons to provide a common denominator for information from seven states, and more importantly, to put the information in numbers that everyone can understand.