Ecosystem changes caused by anthropogenic activities have modified the environment in ways that at times promote the emergence of vector-borne diseases. Here, we study the effects of combined sewage overflows (CSOs) from urban streams in Atlanta, GA, on oviposition site selection by Culex quinquefasciatus under seminatural field conditions. Counting egg rafts was a reliable indicator of oviposition preferences, and CSO water quality, especially when enriched, was a more attractive oviposition substrate than nonenriched water. Therefore, environmentally sound management of municipal waste water systems has the potential to diminish the risk of Culex-borne diseases in urban areas.