A stream-quality reconnaissance at 318 locations in May 1965 offered the first opportunity for a contemporaneous regional collection and appraisal of water-quality data in Appalachia. The results provide a means of regional comparison of the influence of coal-mine drainage on stream quality at approximately median streamflow. The results disclose that the chemical quality of the water at nearly 200 sites did not meet recommended drinking-water standards. At many of these sites, inferior quality was caused by excessive concentrations of solutes commonly associated with coalmine waters. Water-quality damage from mine drainage is particularly severe in the more heavily mined northern one-third of the region where high sulfate content, free mineral acidity, and low pH are typical of most affected streams. A deficiency in natural stream alkalinity in this part of the coal region contributes greatly to the massive effect of mine drainage upon stream quality. However, data collected from streams affected by mine drainage along the west edge of this part of the coal field suggest extensive neutralization of mine water. In southern Appalachia coal-mine drainage had less influence on stream quality than in northern Appalachia. Fewer streams in this area were influenced by mine drainage, and the magnitude of stream damage for affected streams was less than in northern Appalachia.