Water safety is a critical public health and development challenge in Sub-Saharan Africa, where millions lack reliable access to safe drinking water. This chapter examines the status, determinants, and impacts of water safety in the region, focusing on the quality and availability of water sources, contamination risks, and the associated burden of waterborne diseases. Drawing on empirical studies and regional data, it highlights key threats including microbial pathogens, chemical pollutants, inadequate infrastructure, climate variability, urbanization, and displacement. Case studies from countries such as Rwanda, Ghana, Nigeria, and the Horn of Africa illustrate both progress and persistent barriers to water safety. The chapter reviews relevant policy frameworks, such as the WHO Water Safety Plans and regional commitments to Sustainable Development Goal 6, and evaluates community-based and technological interventions aimed at improving water quality. Institutional capacity gaps, fragmented governance, and limited data systems are identified as core obstacles to sustained improvement. The chapter concludes with actionable recommendations focused on strengthening water governance, scaling up investment in infrastructure and hygiene education, and promoting multisectoral collaboration for sustainable, equitable water access.