ORSANCO, established in 1948, is the interstate commission responsible for monitoring, assessing, and protecting water quality along the 981-mile Ohio River and its tributaries—safeguarding drinking water, recreation, and economic vitality for over five million people. The Commission, made up of eight compact signatory states, provides a rare unifying platform to collect, analyze, and respond to water quality data across political boundaries. From long-term trend monitoring and spill response to public communication, ORSANCO plays a critical role during major events like the 2023 East Palestine derailment and the 2015 Ohio River Harmful Algal Bloom, highlighting the power of interstate collaboration and real-time data sharing.