This report on nitrates in water intended for human consumption (WIHC) is Santé publique France’s response, issued in January 2023, to a request for expert advice. This request was made in the context of a formal notice issued by the European Commission for non-compliance with the Drinking Water Quality Directive, due to chronic exceedances of nitrate levels in 213 water distribution units (WDUs), affecting approximately 118,000 residents. The regions most affected are Bourgogne-Franche-Comté, Centre-Val de Loire, Grand Est, Hauts-de-France, Île-de-France, Occitanie, and Pays de la Loire. In response to this situation, French authorities tasked ANSES and Santé publique France with assessing the health risks to populations exposed to these high nitrate concentrations. The risk assessment proposed by Santé publique France is based on a discussion of the feasibility of a quantitative health impact assessment (EQIS); an analysis of nitrate concentration data from the SISE-Eaux system (2010–2019); and a review of the scientific literature on the health effects associated with nitrates. This note presents the results, limitations, and uncertainties of this assessment. The elements discussed therein highlight that, given the current state of knowledge, an EQIS is not feasible. However, current knowledge—both regarding population exposure in France and health risks—is sufficient and justifies the continuation of action measures aimed at limiting nitrate exposure via distributed drinking water. The levers for action are known. They focus on protecting water resources from nitrate contamination; restoring the water quality of contaminated resources, particularly by strengthening the "priority water intake" approach; and, as a last resort, adapting public water supply production systems to ensure that quality limits in distributed water are consistently met. Finally, ANSES’s expertise and recent publications have highlighted a number of associations requiring scientific monitoring on the subject, particularly regarding the occurrence of cancers or perinatal effects. Research should continue to establish a causal link between exposure to nitrates in water intended for human consumption and these health effects, and to account for relevant confounding factors.