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An increase in food-borne illnesses in the United States has been associated with fresh produce consumption. Irrigation water presents recognized risks for microbial contamination of produce. Water quality criteria rely on indicator bacteria. The objective of this review was to collate and summarize experimental data on the relationships between pathogens and thermotolerant coliform (THT) and/or generic E. coli, specifically focusing on surface fresh waters used in or potentially suitable for irrigation agriculture. We analyzed peer-reviewed publications in which concentrations of E. coli or THT coliforms in surface fresh waters were measured along with concentrations of one or more of waterborne and food-borne pathogenic organisms. The proposed relationships were significant in 35% of all instances and not significant in 65% of instances. Coliform indicators alone cannot provide conclusive, non-site-specific and non-pathogen-specific information about the presence and/or concentrations of most important pathogens in surface waters suitable for irrigation. Standards of microbial water quality for irrigation can rely not only on concentrations of indicators and/or pathogens, but must include references to crop management. Critical information on microbial composition of actual irrigation waters to support criteria of microbiological quality of irrigation waters appears to be lacking and needs to be collected.