The regional variability of the probability of occurrence of high total trihalomethane (TTHM) levels was assessed using multilevel logistic regression models that incorporate environmental and infrastructure characteristics. The models were structured in a three-level hierarchical configuration: samples (first level), drinking water utilities (DWUs, second level) and natural regions, an ecological hierarchical division from the Quebec ecological framework of reference (third level). They considered six independent variables: precipitation, temperature, source type, seasons, treatment type and pH. The average probability of TTHM concentrations exceeding the targeted threshold was 18.1%. The probability was influenced by seasons, treatment type, precipitations and temperature. The variance at all levels was significant, showing that the probability of TTHM concentrations exceeding the threshold is most likely to be similar if located within the same DWU and within the same natural region. However, most of the variance initially attributed to natural regions was explained by treatment types and clarified by spatial aggregation on treatment types. Nevertheless, even after controlling for treatment type, there was still significant regional variability of the probability of TTHM concentrations exceeding the threshold. Regional variability was particularly important for DWUs using chlorination alone since they lack the appropriate treatment required to reduce the amount of natural organic matter (NOM) in source water prior to disinfection. Results presented herein could be of interest to authorities in identifying regions with specific needs regarding drinking water quality and for epidemiological studies identifying geographical variations in population exposure to disinfection by-products (DBPs).