This study sought to understand how access to and the quality of water used for human consumption occurs in quilombola communities located in the Amazon region. Four quilombos in Santarém (PA), Amazon region, were selected and a questionnaire was applied to collect data about access and, subsequently, samples (n = 31) of water were collected for microbiological and physical–chemical analysis. The results obtained regarding the potability of the water were compared with the recommendations of Resolution 888/2021 of the Ministry of Health and the analysis of significance was carried out using the t-test (p < 0.005). Access to water for human consumption occurred in different ways through surface collection, artesian wells and springs in the quilombos investigated. The microbiological analyses showed contamination in 90.2% and 61.3% of the samples for total coliforms and Escherichia Coli, respectively. The physico-chemical assessment showed acidic water in 58% of the samples. The parameters of turbidity and apparent color were inconsistent with the recommendations only in the quilombola community that uses surface water for human consumption. Nitrate concentrations in 100% of the samples were within acceptable limits, but the data shows a warning for the concentrations obtained in two of the quilombos investigated, indicating sanitary deficiencies. The water in the quilombos investigated is of compromised quality, especially in terms of microbiological contamination, and could therefore pose a risk to human health, requiring continuous monitoring.