USA Water Polo is responsible for fielding U.S. national teams and hosts 20 annual tournaments.

The United States women's team has competed in every tournament since the inaugural 2000 edition, winning a medal in each, including three consecutive victories in 2012–2021.

In June 2020, USA Water Polo announced it was forming a task force to work on racial justice issues as well as expanding access to the sport.

[10] Four-time olympic champion Brenda Villa was selected alongside executive John Abdou.

[21] USA Water Polo stated it suspended the coach when it first obtained reports about his alleged abuse in January 2018 from the United States Center for SafeSport, but the organization was cautioned for allegedly failing to inform law enforcement at the time as required under California law and the SafeSport code.