More than 20% of sewage waste is dumped untreated into Indore's water supply, while 80% of it's sewers are under-utilized or blocked. Such conditions may increase exposure to microbial pathogens and compromise water potability. This article reports an environmental risk assessment of Indore's Khan River based on existing literature, including hazard identification, dose-response and exposure assessment, identification of susceptible populations, risk characterization, and potential community-oriented management and communication approaches.