Objectives: The paper try to identify the main factors that are contributing to the high prevalence of water-borne diseases among the inhabitants of Karang Islet? As it is surrounded by a lake. Conclusion: After analysis of the causal factors, it was observed that unavailability of potable water, poor sanitation and lack of proper health hygiene, stagnant educational qualification, low socio-economic conditions, cultural practices associated with consumption of drinking water etc., were the main determinants. Therefore, it is need of the hour that some intervention from the government or NGO’s are being required to control the morbidity among this particular people of island dwellers.