We report a simple procedure for rapid, visible light-mediated, controlled radical polymerization in aqueous solutions. Based on the photoelectron transfer reversible addition-fragmentation chain transfer (PET-RAFT) polymerization, fast chain propagation at room temperature in water was achieved in the presence of reductant and without prior deoxygenation. A systematic study correlating irradiation intensity and polymerization kinetics, enabled by in situ nuclear magnetic resonance spectroscopy, provided optimized reaction conditions. The versatility of this procedure was demonstrated through a rapid triblock copolymer synthesis, and incorporation of water-labile activated esters for direct conjugation of hydrophilic small molecules and proteins. In addition, this technique boasts excellent temporal control and provides a wide range of macromolecular materials with controlled molecular weights and narrow molecular weight distributions.