Water quality indices (WQIs), which translate numerical values of several water quality characteristics of a sample into a single value, play a very important role in the monitoring, comparison and control of water quality. The WQIs of modern and post-modern times have been almost exclusively based on physical and chemical characteristics, and have seldom included 'biological' characteristics other than biochemical oxygen demand (BOD) and faecal coliforms. During the last three decades of the 20th century, indices based on bioassessment have been increasingly used in some developed countries, besides South Africa and Serbia, to complement the conventional WQIs, but the rest of the world continues to base its WQIs predominantly on physical and chemical characteristics. The serious drawbacks of this approach have been elucidated in this paper and, against that background, the state-of-the-art of biotic indices has been summarized. The paper makes a strong case for greater reliance on bioassessment-based WQls, especially by developing countries, to strengthen the diagnostic value of the conventional WQls.