Several Cape Town beaches and tidal pools, including Fish Hoek, Strand, Hout Bay, and both Camps Bay tidal pools, have received "red labels" in the city's coastal water quality review, indicating heightened health risks due to elevated bacteria levels. Additional areas, such as Central False Bay, Lagoon beach, Macassar to Gordon’s Bay, and Three Anchor Bay beach, face persistent water quality challenges. The City's water testing, covering 99 coastal sites, categorizes results as excellent, good, sufficient, or poor.

Despite claims by the City's coastal management manager, Greg Oelofse, that overall water quality remains "relatively good," water treatment expert Professor Leslie Petrik warns of significant health risks akin to "playing Russian roulette" for swimmers along Cape Town's coastline. Petrik attributes these risks to failing pump stations, sewage spills, and pollution. The Blue Drop Report highlights inadequacies in meeting safety criteria.

Deputy Mayor Eddie Andrews touts "excellent" water quality at Cape Town's popular beaches, based on independent analysis over seven weeks. However, conflicting results from the city's water quality dashboard and Professor Petrik's warnings cast doubt on the claim. Land-based pollution, impacting areas like Diep River estuary mouth, Disa River mouth, Else River mouth, Silvermine River mouth, and Gordon’s Bay River, contributes to variable results.

Specific sites, such as Camps Bay Tidal Pool A, near a sewage pump station outlet, prompt concerns despite the beach receiving Blue Flag status. Professor Petrik challenges the classification, citing frequent sewage spills.

Warnings of varying risks emphasize the need to address pollution sources, with Caroline Marx from Rethink the Stink urging resolution rather than reliance on warning signs. Untreated sewage discharge from Hout Bay, Green Point, and Camps Bay marine outfalls raises environmental and health concerns, contested by the city's claims of adherence to water quality guidelines.

The DA has been governing Cape Town since 2006, but it is only recently, under the new mayor Geordin Hill-Lewis, that efforts have begun to remedy the longstanding problem.

The City of Cape Town's Mayoral Committee approved contracts for the R5-billion upgrade of Potsdam Wastewater Treatment Works (WWTW) in March. The project aims to increase capacity from 47 million to 100 million liters of treated wastewater daily, incorporating membrane technology for higher treatment standards.

The upgrade is a key step in restoring Milnerton Lagoon's health, with a study on short-term interventions underway. The 2023/24 Budget proposes R8.6 billion for wastewater treatment works upgrades and R1.4 billion for bulk sewer upgrades.

The City is currently facing legal challenges from Action SA concerning their chronic neglect of sewage treatment infrastructure.