Objective To analyze the main risk factors affecting the water quality of rural centralized water supply projects in China, and to provide a reference for further improving the quality of rural drinking water.

Methods Basic information collection and hygienic survey of 494 rural centralized water supply projects in China were conducted in 2020—2022. Descriptive analysis of the basic characteristics of the projects was carried out. Multivariate logistic regression was used to determine the factors affecting water quality and to find out the hygienic risks.

Results The qualified rate of tap water of 494 investigated projects was 85.4%. The qualified rates of tap water in 2020, 2021, and 2022 were 75.8%, 90.0%, and 91.0%, respectively. Multivariate logistic regression showed that the type of water source, the existence of regular inspection and accident response mechanism, and quality test of effluent water according to the requirements for indicators and frequency were the risk factors for the qualification of tap water.

Conclusion The water quality of China's rural centralized water supply projects still needs to be improved. Water source and hygiene management are the main factors affecting the qualified rate of tap water. It is recommended to strengthen the protection of water sources and optimize the management measures to guarantee the safety of drinking water in rural areas.