Climatic conditions strongly impact the incidence and transmission of many waterborne and foodborne diseases. Climate change may increase the risk to these illnesses by influencing weather patterns, resulting in warmer temperatures, more variable rainfall events and decreased water availability. The extent to which these changes will increase the burden of disease is uncertain, however there are implications for many exposure pathways. In addition to infectious disease agents, the transport and fate of chemicals such as heavy metals and organic compounds in the environment will be affected by changing water flows. In water stressed areas, reductions in fresh water availability due to climate change will have critical implications for water quality, disproportionately affecting vulnerable groups such as children. Decreased water resources will also have consequences for safe food processing and preparation.