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Abstract: The Tiber constituted the Romans’ only source of water until the mid sixteenth century, with the exception of the Vergine aqueduct, which had intermittently served the central part of the city in the previous centuries, as the ancient aqueducts had ceased to furnish the population for more than a thousand years. Even the popes used the water from the Tiber, preferring it to that of the limited wells, located within the Aurelian Walls. The dependence on the Tiber nourished particular forms of commerce, such as that of water vendors. Doctors had in fact, recommended using the water only after it had decanted for a period of time: that meant that before being able to drink it, it was necessary to leave it in special basins for several months. However, only the nobility and high prelates owned such equipment and the general population had to be served by the so called acquaroli or water peddlers who sold the already decanted water. These itinerant vendors, who carried the water from neighborhood to neighborhood in barrels loaded on donkeys, could also offer other waters, both from wells and other torrents that fed the city. Obviously the fact that everybody could obtain water at little cost by taking it directly from the river, had contributed to postpone the repair of the ancient Roman aqueducts over the centuries. As of the Middle Ages, the dependence on the Tiber had repercussions on reshaping the city, contributing to limiting the built city to the course of the river and, at the same time, inducing the abandonment of the higher areas that were no longer served by those aqueducts that had been repeatedly destroyed by the enemy armies which had besieged the city beginning in the sixth century.