Intentional or accidental releases of contaminants into a water distribution system (WDS) have the potential to cause significant adverse health effects among individuals consuming water from the system. A flexible analysis framework is presented here for estimating the magnitude of such potential effects and is applied using network models for 12 actual WDSs of varying sizes. Upper bounds are developed for the magnitude of adverse effects of contamination events in WDSs and evaluated using results from the 12 systems. These bounds can be applied in cases in which little system-specific information is available. The combination of a detailed, network-specific approach and a bounding approach allows consequence assessments to be performed for systems for which varying amounts of information are available and addresses important needs of individual utilities as well as regional or national assessments. The approach used in the analysis framework allows contaminant injections at any or all network nodes and uses models that (1) account for contaminant transport in the systems, including contaminant decay, and (2) provide estimates of ingested contaminant doses for the exposed population. The approach can be easily modified as better transport or exposure models become available. The methods presented here provide the ability to quantify or bound potential adverse effects of contamination events for a wide variety of possible contaminants and WDSs, including systems without a network model.