Poor drinking water quality is a global crisis that affects billions of individuals. Understanding who is most impacted is necessary to develop programs that ensure sustainable, reliable, and resilient access to safe water. But current water indicators do not capture people’s experienced and anticipated harm from drinking water, which means we have had limited understanding of how individuals conceptualize, navigate, and are affected by their water environment. Here, we analyzed data from nationally representative surveys undertaken in 142 countries in which people reported their recent experiences and future expectations of harm from drinking water. Prevalence of reported harm from drinking water in the prior two years was 14.5% (range: 0.8%–54.3%). More than half of the world’s population (54.4%) anticipated that they would experience serious harm from their drinking water in the next two years. Greater public sector corruption was associated with greater anticipated harm from drinking water, even when adjusting for indicators of water infrastructure and economic development. Disparities in anticipated harm across countries and by gender and household location indicate that targeted policies are required to address risk perceptions, equitably improve access to safe drinking water, and increase trust in institutions that supply and regulate water services. The addition of experiential survey data to global data collection efforts will complement objective water quality data and provide novel insights about which strategies will most effectively advance progress toward safe drinking water for all.