Monitoring of cyanobacteria and their associated toxins has intensified in raw water sources of drinking water treatment plants (WTPs) in most countries of the world. However, it is not explored yet for Egyptian WTPs. Therefore, this study was undertaken to investigate the occurrence of cyanobacteria and their microcystin (MC) toxins in the Nile River source water of Damietta WTP during warm months (April-September 2013) and to evaluate the removal efficiency of both cyanobacterial cells and MCs by conventional methods used in this plant as a representative of Egyptian drinking WTPs. The results showed that the source water at the intake of Damietta WTP contained dense cyanobacterial population (1.1-6.6 × 107 cells L(-1)) dominated by Microcystis aeruginosa. This bloom was found to produce MC-RR and MC-LR. Both cyanobacterial cell density and intracellular MCs in the intake source water increased with the increase in temperature and nutrients during the study period, with maximum values obtained in August. During treatment processes, cyanobacterial cells were incompletely removed by coagulation/flocculation/sedimentation (C/F/S; 91-96.8%) or sand filtration (93.3-98.9%). Coagulation/flocculation induced the release of MCs into the ambient water, and the toxins were not completely removed or degraded during further treatment stages (filtration and chlorination). MCs in outflow tank water were detected in high concentrations (1.1-3.6 μg L - 1), exceeding WHO provisional guideline value of 1 μg L - 1 for MC-LR in drinking water. Based on this study, regular monitoring of cyanobacteria and their cyanotoxins in the intake source water and at different stages at all WTPs is necessary to provide safe drinking water to consumers or to prevent exposure of consumers to hazardous cyanobacterial metabolites.