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Accidental pollution in the Danube River Basin can cause widespread damage to the environment, and endanger the health of local people and the state of local economies downstream. This was exemplified by the effects of the Baia Mare cyanide spill in Romania in 2000 or by the Hungarian redsludge accident at Ajka in 2010. The ICPDR is working to prevent accidental pollution and to improve response capability by compiling an inventory of all relevant "Accident Risk Spots".

Organic pollution has been on the rise in the Danube over the last century, as human activities have resulted in increasing loads of wastewater rich in organic matter. The most serious organic pollution problems occur in tributaries that regularly receive untreated or inadequately treated wastewater from industrial plants and municipalities. Thanks to the significant improvement of wastewater infrastructure and services in the Danube countries, the basin-wide organic emissions reduced by 60% since the mid 2000s.