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Water quality trading (WQT) programs aim to efficiently reduce pollution through market-based incentives. However, WQT performance is uneven, while several programs have found frequent use, many experience operational barriers and low trading activity. What factors are associated with WQT existence, prevalence, and operational stage? In this paper, we present and analyze the most complete database of WQT programs in the United States (147 programs/policies), detailing market designs, trading mechanisms, traded pollutants, and segmented geographies in 355 distinct markets. We use hurdle models (joint binary and count regressions) to evaluate markets in concert with demographic, political, and environmental covariates. We find that only one half of markets become operational, new market establishment has declined since 2013, and market existence and prevalence has nuanced relationships with local political ideology, urban infrastructure, waterway and waterbody extents, regulated environmental impacts, and historic waterway impairment. Our findings suggest opportunities for better projecting program need and targeting program funding.