• Toxicity-oriented water quality monitoring was proposed. • Toxicity-oriented water quality engineering control was proposed. • Future issues to the proposition were discussed. The fundamental goal of water quality engineering is to ensure water safety to humans and the environment. Traditional water quality engineering consists of monitoring, evaluation, and control of key water quality parameters. This approach provides some vital insights into water quality, however, most of these parameters do not account for pollutant mixtures – a reality that terminal water users face, nor do most of these parameters have a direct connection with the human health safety of waters. This puts the real health-specific effects of targeted water pollutant monitoring and engineering control in question. To focus our attention to one of the original goals of water quality engineering – human health and environmental protection, we advocate here the toxicity-oriented water quality monitoring and control. This article presents some of our efforts toward such goal. Specifically, complementary to traditional water quality parameters, we evaluated the water toxicity using high sensitivity toxicological endpoints, and subsequently investigated the performance of some of the water treatment strategies in modulating the water toxicity. Moreover, we implemented the toxicity concept into existing water treatment design theory to facilitate toxicity-oriented water quality control designs. Suggestions for the next steps are also discussed. We hope our work will intrigue water quality scientists and engineers to improve and embrace the mixture water pollutant and toxicological evaluation and engineering control.