Aims: Programs to notify the public about water quality at beaches are developed at the state and local levels. We sought to characterize the messages and message delivery options in use, and information about the effectiveness of these beach notification programs. Methods: A telephone survey of 37 US state, tribal and territorial and 18 county, city or local beach programs was conducted to characterize current public notification practices and any evaluations of those practices. Results: Beach notification practices vary substantially at the state and local levels. Color-coded signs or flags are commonly used, but not universally, and the color schemes and their meanings vary. New communication approaches utilizing text messaging and the internet are in use or under development for local use. Few communication methods had undergone systematic evaluations of their content, delivery methods or effectiveness in promoting behavior change. Conclusion: The prevention of waterborne illness requires communications that effectively promote the avoidance of swimming when water quality is impaired. Current communication practices are variable and generally have not undergone formal evaluations for their effectiveness. It is not known whether or how they impact health risk.