BACKGROUND: Evidence from the Early 2000s quantified limited coverage of household water supplies in countries of the former Soviet Union. The study objectives were to measure changes in access to piped household water in seven of these countries between 2001 and 2010 and examine how these varied by household economic status. METHODS: Cross-sectional household sample surveys were conducted in 2010 in Armenia, Belarus, Georgia, Kazakhstan, Moldova, Russia and Ukraine. Data on household piped water were compared with a related 2001 study and descriptive, regression and relative risk analyses applied. RESULTS: Increases in access to piped water in the home between 2001 and 2010 were recorded in urban and rural areas of all countries, except Kazakhstan. Access remains lower in rural areas. The relative risk of urban households not having piped water in 2010 compared with 2001 diminished by one-third for households with a bad/very bad economic situation [rate ratio (RR): 0.66] and by half for wealthier households (RR: 0.48). In rural areas, the declines were 15% for households with a bad/very bad economic situation (RR: 0.85) and 30% for wealthier households (RR: 0.69). CONCLUSIONS: Despite encouraging increases in access to piped water, there remain significant gaps for rural and poorer households.