Cyanobacteria have adapted to survive in a variety of environments and have been found globally. Toxin-producing cyanobacterial harmful algal blooms (CHABs) have been increasing in frequency worldwide and pose a threat to drinking and recreational water. In this study, the prevalence, impact of CHABs and mitigation efforts were reviewed, focusing on the Lake Erie region and Ohio's inland lakes that have been impacted heavily as an example so that the findings can be transferrable to other parts of the world that face the similar problems due to the CHABs in their freshwater environments. This paper provides a basic introduction to CHABs and their toxins as well as an overview of public health implications including exposure routes, health effects, and drinking water issues, algal bloom advisory practices in Ohio, toxin measurements results in Ohio public water supplies, and mitigation efforts.