The presence of Salmonella in rivers, lakes, or beaches in South America represents a challenge to public health and aquatic ecosystems. This review explores the distribution, prevalence, and the main factors contributing to the survival and spread of Salmonella, including wastewater discharge, agricultural runoff, and climatic variables such as high temperatures and precipitation. These factors also facilitate the distribution of multidrug-resistant strains in water. The review is based on bibliographic searches in various databases, focusing on Salmonella species, South American countries, and types of water bodies. Predominant serovars include S. Enteritidis and S. Typhimurium, with S. Typhi and S. Panama frequently detected in Chile, S. Enteritidis in Argentina, and S. Typhimurium in Brazil. Less common serovars, including S. Dublin and S. Paratyphi B, were identified, along with subspecies such as diarizonae and houtenae. These findings highlight the role of environmental, physicochemical, and anthropogenic factors influencing Salmonella dynamics. The review identifies research gaps, advocating for further studies to better understand the interactions between Salmonella, climate change, and human activity. Strengthening surveillance and mitigation strategies is crucial to protect water resources and public health in South America.