We evaluated a household hollow fiber water filter program in 11 Honduran villages by assessing filter uptake and water quality. Filters were purchased by 90% of households; of these, 94% reported use within the past week. When comparing water treatment methods between baseline and follow-up, there were increases in the proportion of households reporting water treatment (74% vs. 93%, p < 0.001) and treatment by filtration (19% vs. 85%, p < 0.001), and decreased purchase of bottled water (44% vs 6%, p < 0.001), indicating acceptability of the water filtration systems. There was a significant decrease in the presence of Escherichia coli in water samples taken from 35 households at baseline and follow-up in water filter systems (p < 0.001). As a result, 68% of samples met WHO water quality guidelines (no detectable E. coli) 6–12 months after program implementation. Observations of filter stands revealed a 6-inch gap between the top (reservoir) bucket and bottom (filtrate recipient) bucket that could have permitted animals, insects, hands, or other objects to touch filtered water. We recommend a redesign of filter stands to eliminate the gap between buckets, and a longer-term follow-up to assess filter durability and performance.