This paper presents a case study focusing on the impacts of combined sewer overflows on the water quality of the receiving water body, Hatirjheel. Hatirjheel, the largest surface water body in Dhaka City with an area of about 1.012 km2, receives discharges from nine combined sewer overflow (CSO) structures. The water quality of Hatirjheel is poor throughout the year, but particularly during the wet season (June to October) near the CSO structures through which significant rainwater-sewage overflows. The water has been found to contain high concentrations of 5-day biochemical oxygen demand (BOD5) and chemical oxygen demand; some of the BOD5 values exceed the national discharge standards for treated effluents. Total ammonia concentration in Hatirjheel water increases during the wet season, often exceeding 20 mg/l; the concentration continues to increase after the end of the wet season, most likely due to the ammonification process. Nitrate concentration in Hatirjheel water increases at the end of the wet season, possibly due to nitrification; subsequent reduction in nitrate and ammonia concentration is possibly due to incorporation of nitrogen into algal mass. Excessive phosphorus in Hatirjheel promotes eutrophication, resulting in the visible greenish color of the water. This study highlights the significant adverse impact of combined sewer overflows, particularly for a densely populated city like Dhaka, where most of the rainfall occurs within a relatively short period during monsoon.ArticleHighlightsCombined sewer overflows could significantly deteriorate the water quality of the receiving water bodies.Sewer overflows create a significant spatiotemporal variation of water quality, with higher pollution close to the overflowing combined sewer overflow structures.Because of its significant adverse impact on water quality and ecology, combined sewer systems may not be viable for high-density urban areas.