Coagulation is a critical-but highly complex-process in drinking water treatment. Variations in pH, temperature, source water composition, coagulant type, and other conditions collectively influence the process and confound efforts to quantitatively predict coagulation outcomes. Yet, qualitative understanding is possible through synthesis of the extensive literature. This review describes hydrolysis reactions of metal salts and summarizes variables that influence the characteristics of the resulting precipitates. Thereafter, properties of two key contaminants, turbidity and natural organic matter (NOM), are explored in the context of removal during coagulation. Finally, the significance of source water quality and co-occurring ions is described.