Disinfection of water supplies with chlorine is essential to water treatment, but can lead to the formation of trihalomethanes (THMs) in the presence of natural organic matter. Exposure to THMs via inhalation during daily activities such as showering can significantly increase cancer risks. An innovative decision support system was developed for evaluating THM exposure and risks in water supplies in the Gulf Coast region of Texas by combining a shower THM volatilization model, geospatial analysis techniques, and risk assessment methodologies. Based on THM data from fourteen locations in the region, a power-law equation was developed to predict the formation of THMs in groundwater wells. Health risks associated with THMs in the water supplies of the Gulf Coast of Texas were evaluated. Cancer risks were found to vary from 7.14 × 10−7 to 7.75 × 10−6. While two-thirds of the geographical area was below the threshold risk of 1 × 10−6, it accounted for only a tenth of the total population. Metropolitan areas such as Corpus Christi and McAllen, which currently use surface water sources, and Houston, which is seeking alternate water sources due to subsidence issues, were found to have significant cancer risks (in excess of one in a million). A third of the population of Texas is housed in the Gulf Coast region, and with more population migration toward the metropolitan areas, it is recommended that water resource management decisions be made taking into consideration both the quantity and quality of water available.