The unsanitary conditions caused an increase in disease. Epidemics like cholera and yellow fever ravaged the city. A polluted aquifer, overcrowded housing, the lack of sewers, public ignorance of basic sanitary conditions, and the existence of polluting industries near wells and residential areas contributed to an unprecedented mortality rate of 1 death per 39 inhabitants in 1830. In addition, the rapid expansion in densely-packed wooden buildings, combined with a lack of an adequate water supply, led to many fires, culminating in the 1835 Great Fire of New York, which destroyed large parts of the city.
The need for a new supply of fresh water was crucial and in 1837 construction began on a massive engineering project to divert it from sources upstate. Supervised by Chief Engineer John B. Jervis, the Croton River was dammed, aqueducts were built, tunnels dug, piping laid and reservoirs created. Iron piping encased in brick masonry was laid from the Croton Dam in northern Westchester County to the Harlem River, where it continued over the High Bridge at 173rd Street and down the west side of Manhattan and finally into a Receiving Reservoir located between 79th and 86th streets and Sixth and Seventh Avenues that is now the site of the Great Lawn in Central Park. The Receiving Reservoir was a fortress-like building long and wide, and held up to 180 million gallons of water. Thirty-five million gallons flowed into it daily from northern Westchester.
From the Receiving Reservoir water flowed down to the Distributing Reservoir, better known as the Croton Reservoir, a similar fortification located on Fifth Avenue between 40th Street and 42nd Street, where the main branch of the New York Public Library and Bryant Park are located today. This reservoir was built to resemble ancient Egyptian architecture.
The Aqueduct opened to public use with great fanfare on October 14, 1842. The day-long celebration culminated in a fountain of water that spouted to a height of fifty feet from the beautifully-decorated Croton Fountain in City Hall Park. Among those present were then-President of the United States John Tyler, former presidents John Quincy Adams and Martin van Buren, and Governor of New York William H. Seward.
Water started flowing through the aqueduct on June 22, 1842, taking 22 hours for gravity to take the water the 41 miles (66 km) to reach Manhattan. Even though only 6,175 houses had been connected to the system by 1844, the Croton water had already dramatically impacted both domestic hygiene and interior design. Baths and running water were being built in the private homes of wealthy New Yorkers and public bathing facilities were created for the masses. The water system had another inadvertent beneficial consequence. The decline in the number of residents drawing water from the city's wells resulted in a rise in the water table which flooded many cellars. To address this problem, the city built sewers in many residential streets. By 1852, of sewers had already been constructed.
About this time the German cockroach attracted attention, and was called "Croton bug" on the mistaken assumption that the aqueduct brought the insects into the homes being connected to the new water supply system.
The capacity of the Old Croton Aqueduct, large as it was, could not keep up with the growth of New York City, and construction on a New Croton Aqueduct began in 1885; it went into service in 1890, with triple the capacity of that of the Old Croton Aqueduct. It currently supplies ten percent of New York City's water. The Croton Reservoir continued to supply New York City with drinking water until 1940, when Commissioner of Parks and Recreation Robert Moses ordered it drained and filled to create the Great Lawn in Central Park.
Today, remnants of the aqueduct still exist. Although much of the original masonry has been either removed or covered up by growth, a frequently-used walking and bicycling path runs along the easement of the former aqueduct. The Old Croton Trailway State Historic Park and Trail extends for in Westchester, providing public access along all but four segments (in southern Yonkers, Tarrytown, Scarborough, and Ossining) of the route, including across the lawn of Lyndhurst. Access is easiest where it crosses Route 9, also known as the Albany Post Road, Broadway or Highland Avenue. The Trail enters New York City at Van Cortlandt Park and runs through the Bronx alongside Aqueduct Avenue and under the southern part of University Avenue.
A portion of the Old Croton Aqueduct, running from the Croton River to Manhattan, was listed as a National Historic Landmark in 1992. The aqueduct also is listed as a Historic Civil Engineering Landmark.
The interior of the Old Croton Aqueduct has been explored and documented by Miru Kim and “guerrilla historian” Steve Duncan. The aqueduct also plays an important role in E. L. Doctorows novel The Waterworks (novel).