Reliability centered maintenance (RCM) is a process used to determine the most effective maintenance approach, the goal being to establish the required function of a component with the required reliability and availability at the lowest cost. The RCM philosophy considers preventive maintenance, predictive maintenance, condition based monitoring, reactive maintenance, and proactive maintenance techniques in an integrated manner to increase the probability an asset will perform its designed function throughout its design life with minimal maintenance. The principles underlying RCM are so diverse they can be applied to any asset. RCM has been used by aircraft manufacturers, nuclear power plants, submarines, surface ships, automobile manufacturers, HVAC systems, breweries, hospitals and medical equipment, railroads, electrical power facilities, oil and gas, and militaries across the globe. RCM principles can be widely applied to an entire asset or more narrowly applied to select pieces of equipment comprising the asset. In all applications, RCM requires maintenance decisions be based on maintenance requirements supported by sound technical and economic justification. However, one industry where principles of RCM are in its infancy is the water/wastewater industry. The American Water Works Association's (AWWA) 2020 State of the Water Industry report states that the top issue facing the water industry since 2016 is aging infrastructure, with the second being financing for improvements. The industry needs to find novel ways of extending asset life and reducing maintenance expenditures. While there are many different assets that comprise the water/wastewater industry, pipelines are a major component and are often neglected because they are typically buried. This paper reviews several current models used in RCM analyses and proposes an approach for determining the most effective and efficient maintenance activities for large diameter water pipelines.