Sewage treatment (or domestic wastewater treatment, municipal wastewater treatment) is a type of wastewater treatment which aims to remove contaminants from sewage to produce an effluent that is suitable to discharge to the surrounding environment or an intended reuse application, thereby preventing water pollution from raw sewage discharges. There are a high number of sewage treatment processes to choose from. These can range from decentralized systems (including on-site treatment systems) to large centralized systems involving a network of pipes and pump stations (called sewerage) which convey the sewage to a treatment plant.

For cities that have a combined sewer, the sewers will also carry urban runoff (stormwater) to the sewage treatment plant. A large number of sewage treatment technologies have been developed, mostly using biological treatment processes. Design engineers and decision makers need to take into account technical and economical criteria of each alternative when choosing a suitable technology. Often, the main criteria for selection are: desired effluent quality, expected construction and operating costs, availability of land, energy requirements and sustainability aspects.