Access to microbiologically safe drinking water remains a major challenge in improving people's living conditions. In Bouake (Central Côte d’Ivoire), good quality water is widely used for domestic purposes without adequate safety assurance. This study assessed the microbiological quality of 30 drinking water samples and examined associated health risks and household water management practices. The results revealed large contamination by faecal bacteria, particularly intestinal enterococci and Escherichia coli, at concentrations greatly exceeding regulatory standards. Other contaminants, such as total coliforms, Pseudomonas aeruginosa and sulphite-reducing Clostridium, were frequently detected, indicating recent and chronic faecal pollution. The household survey showed that an approximate 50 percent (49.33%) of the respondents consumed untreated drinking water. Waterborne diseases recorded were diarrhea (30%), helminth infections (15%), and typhoid fever (10%). Most wells were communal and widely used for domestic purposes. These results highlighted a major public health concern and an urgent need for interventions for improving water safety and promoting effective household water treatment practices.