The Mearim River Watershed has multiple uses e.g. leisure, navigation, fishing and subsistence agriculture and constitutes the main source of supply for the populations of municipalities situated along its course. In addition to being a water supply source, the existence of the ‘pororoca’ (tidal bore) effect in a stretch of the lower course of the Mearim River attracts people from several Brazilian states and different countries, as it offers excellent conditions for surfing in fresh water. In this respect, given the importance of the watershed, this study was developed to report the detection of diarrheagenic Escherichia coli pathotypes in a stretch of the lower course of the Mearim River, located in the state of Maranhão, Brazil. Thirty water samples were collected from 10 sampling points. To quantify E. coli, the chromogenic enzymatic system was used and positive samples were isolated and biochemically identified. Pure cultures underwent DNA extraction by heating followed by polymerase chain reaction (PCR) characterization. At the time of the collections, an observation schedule was used to record information on the existence of rearing of livestock and domestic animals; businesses; residences; and fruit and vegetable farming on the riverbanks. The samples were analyzed for the mean populations of E. coli, which ranged from 444 to 2,585 MPN mL-1. Twenty bacterial isolates were identified and the diarrheal pathotypes ETEC, typical EPEC and atypical EPEC were detected. The detection of these pathotypes can represent an epidemiological risk and compromise several uses of this water resource, such as irrigation of fruits and vegetables consumed raw, fishing, animal watering and recreation. Structural investments in basic sanitation are essential to minimize environmental degradation resulting from anthropic activities and to act preventively in public health. In addition, the recovery of riparian forests along the watershed and the maintenance of vegetation in these areas are measures to reduce the transport of particles from the soil to the watercourses, improving the qualitative and quantitative characteristics of this water resource.