The research intended to establish the relationship between Zvishavane domestic water quality and selected disease patterns. Total levels of coliform, Escherichia Coli, chemical and other physical parameter levels in samples from selected water sources during the period March 2018 to January 2019 were evaluated. Zimbabwe National Water Authority (ZINWA) commercial laboratory methods were used to analyze thirty one randomly selected sources. This quantitative research results were compared with recommended limits from Standard Association of Zimbabwe (SAZS 560:1997) and World Health Organization (WHO).Five water sources had coliform counts ranging from < 1 to 55 cfu per 100 ml and Escherichia Coli from < 1 to 28 cfu per 100 ml. Chloride levels of above 200 mg/L were obtained from eight borehole water sources. Levels of selected heavy metal ions were within the SAZS 560:1997 maximum allowable limits in all water samples. Sample levels for Mg 2+ (29 %) and total hardness (32%) were above the maximum allowable levels. Tap water samples were within recommended limits for all measured parameters. Hypertension was first among the chronic disease conditions while diarrhoea and dysentery ranked second of the outpatient general diseases attended to at the Zvishavane District Hospital during 2018. 66 neonatal death were reported during the same time period. Zvishavane domestic water require research based pre-treatment methods before drinking. There is a possible link between the quality of water and the disease patterns. However these observations require further epidemiological studies to confirm the link.