Synthetic musk fragrances are common personal care product additives and wastewater contaminants that are routinely detected in the environment. This study examines the presence of eight synthetic musk fragrances [7-acetyl-1,1,3,4,4,6-hexamethyl-1,2,3,4-tetrahydronaphthalene (AHTN), 1,3,4,6,7,8-hexahydro-4,6,6,7,8-hexamethylcyclopenta-γ γγ -2-benzopyran (HHCB), 5-acetyl-1,1,2,6-tetramethyl-3-iso-propylindane (ATII), 4-acetyl-1,1-dimethyl-6-tert-butylindane (ADBI), 6-acetyl-1,1,2,3,3,5-hexamethylindane (AHMI), 6,7-dihydro-1,1,2,3,3,-pentamethyl-4-(5H)-indanone (DPMI), 1-tert-butyl-3,5-dimethyl-2,4,6-trinitrobenzene (musk xylene), and 4-tert-butyl-3,5-dinitro-2,6-dimethylacetophenone (musk ketone)] in source water and the removal of these compounds as they flow through a Midwestern conventional drinking water plant with lime softening. The compounds were measured in water, waste sludge, and air throughout the plant. HHCB and AHTN were detected in 100% of the samples and at the highest concentrations. A mass balance on HHCB and AHTN was performed under warm and cold weather conditions. The total removal efficiency for HHCB and AHTN, which averaged between 67–89%, is dominated by adsorption to water softener sludge and its consequent removal by sludge wasting and media filtration. Volatilization, chlorine disinfection, and the disposal of backwash water play a minor role in the removal of both compounds. As a result of inefficient overall removal, HHCB and AHTN are a constant presence at low levels in finished drinking water.