Environmental waters are important reservoirs of pathogenic microorganisms, many of which are of fecal origin. In most cases, the presence of pathogens is determined using surrogate bacterial indicators. In other cases, direct detection of the pathogen in question is required. Microbiological methods to determine the presence of indicator organisms or pathogens in environmental samples vary depending on the target organism, sample type, need for quantification, speed of detection, sensitivity, and detection limits. Classical methods depend on cultivation steps while emerging techniques rely on detecting genetic signals from nucleic acid extracted from water samples. Regardless of the method, accurate detection is important to public health officials and monitoring agencies. In this article, we review some of the methods used to detect and quantify indicators of microbial water quality and human fecal pathogens as well as other issues relevant to water fecal pollution.