<p>Access to safe drinking water and decent sanitation is a basic human right, yet most people in developing countries, particularly in Sub-Saharan Africa, lack access to them. The problem of inadequate clean water becomes complicated when biological and chemical agents contaminate available water sources. In Nigeria, bacterial water contamination is common; however, in recent literature, there is a lack of synthesis linking drinking water contamination with the emergence of antibiotic-resistant bacteria (ARB), including how the drinking water ecosystem may contribute to the spread of antibiotic resistance (AR). In addition, the microbiological mechanism that ensures the persistence of ARB in drinking water needs to be fully explored. Thus, this review integrates evidence on bacterial contamination and evaluates the role of drinking water in the dissemination of AR in Nigeria, including the contributions of poor sanitation, industrial effluents, abattoir operations, leachates from dumpsites, agricultural practices, and runoff from farm fields to the bacteriological quality of surface and underground water, and their consequences on human health. Also expanded are the processes leading to the emergence of ARB in water contaminated by sewage from domestic and pharmaceutical sources. Anthropogenic water contamination results in the emergence of ARB carrying transmissible antibiotic resistance genes (ARGs) in drinking water, thus highlighting the need to eliminate bacterial contamination of drinking water sources to protect public health and ensure the sustainability of water resources. Integrating surveillance for AR in environmental and treated water into the national antimicrobial resistance surveillance network is recommended to control the spread and reduce the burden of waterborne antibiotic-resistant bacteria in Nigeria.</p>