Consumers assess their tap water primarily by its taste, odor, and appearance. Starting in 1979, USEPA promulgated Secondary Maximum Contaminant Levels (SMCLs) as guidance for contaminants with organoleptic effects and also to maintain consumers’ confidence in tap water. This review assesses the basis for the 15 SMCLs (aluminum, chloride, color, copper, corrosivity, fluoride, foaming agents, iron, manganese, odor, pH, silver, sulfate, total dissolved solids, zinc) and summarizes advances in scientific knowledge since their promulgation. SMCLs for aluminum, color, pH, silver, sulfate, total dissolved solids, and zinc are appropriate at current values and remain consistent with sensory science literature. Recent advances in sensory and health sciences indicate that SMCLs for chloride, copper, fluoride, iron, and manganese are too high to minimize organoleptic effects. The SMCLs for corrosivity and foaming agents may be outdated. The SMCL for odor requires rethinking as the test does not correlate with consumer complaints. Since current stresses on source and treated waters include chemical spills, algal blooms, and increased salinization, organoleptic episodes that negatively impact consumer confidence and perception of tap water still occur and may increase. Thus, adherence to SMCLs can help maintain production of palatable water along with consumers’ confidence in their water providers.