Water quality monitoring is an essential component of water quality management for water utilities for managing the drinking water supply. Online UV-Vis spectrophotometers are becoming popular choices for online water quality monitoring and process control, as they are reagent free, do not require sample pre-treatments and can provide continuous measurements. The advantages of the online UV-Vis sensors are that they can capture events and allow quicker responses to water quality changes compared to conventional water quality monitoring. This review summarizes the applications of online UV-Vis spectrophotometers for drinking water quality management in the last two decades. Water quality measurements can be performed directly using the built-in generic algorithms of the online UV-Vis instruments, including absorbance at 254 nm (UV254), colour, dissolved organic carbon (DOC), total organic carbon (TOC), turbidity and nitrate. To enhance the usability of this technique by providing a higher level of operations intelligence, the UV-Vis spectra combined with chemometrics approach offers simplicity, flexibility and applicability. The use of anomaly detection and an early warning was also discussed for drinking water quality monitoring at the source or in the distribution system. As most of the online UV-Vis instruments studies in the drinking water field were conducted at the laboratory- and pilot-scale, future work is needed for industrial-scale evaluation with ab appropriate validation methodology. Issues and potential solutions associated with online instruments for water quality monitoring have been provided. Current technique development outcomes indicate that future research and development work is needed for the integration of early warnings and real-time water treatment process control systems using the online UV-Vis spectrophotometers as part of the water quality management system.