An overview of water availability and distribution, water consumption, wastewater treatment trends, with particular reference to advanced ones, is briefly presented. Data about the current situation of municipal wastewater treatment and advanced treatment options are presented and regional trends about wastewater reclamation (agricultural and industrial reuse) are summarised. Some considerations about present and possible future standards, both for disposal into surface waters and for wastewater reclamation in agriculture are discussed. A short list of examples in the field of advanced wastewater treatment and reclamation in various Italian regions is presented and some information about environmental crisis areas in Italy is given.