Abstract Various types of microorganisms have been found to inhabit the inner surfaces of asbestos cement (AC) pipe and their activities can cause significant structural damage. They cause a patina to form on the inside surface of AC pipes as a distinctively continuous coating, commonly 2–5 mm in thickness and generally pigmented as yellow, orange, brown or black depending on the metallic cations that have been incorporated into the surface of biofilm (bioaccumulation). Four sublayers can be identified in the patina, from the outer sublayer that directly interacts with the conveyed drinking water to the inner sublayer that is in proximity of the intact cement matrix. The microbes in the outer sublayer are composed mainly of inactive biomass that separates the aerobic environment of the flowing water from the anaerobic conditions inside the patina. The bacteriological community structure shifts from mixed heterotrophic bacteria (HAB), iron-related bacteria (IRB) and slime-forming bacteria (SLYM) in the outer layer, to a more diverse community with IRB, acid-producing bacteria (APB) and SLYM and HAB in the middle sublayer, and further to the SLYM dominated in the inner sublayer. By directly interacting with cementitious materials, including generating organic acids, IRB and APB play important roles in the leaching of free lime and the dissolution of calcium (Ca)-bearing hydrated components of AC pipes, creating porous structure and reducing the pipe strength. Scanning electron microscopy with an energy dispersive X-ray has revealed that bacterial activity on the internal AC pipe wall had resulted in a significant loss of hydrated cement matrix, which can cause pipe failure when stresses imposed on the pipe exceed the remaining pipe strength.